A Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients

Validation of a dietary record routine in geriatric patients using doubly labelled water

“…Interestingly, these factors would contribute to a lack of body weight stability and keep the patient out of this study. Also, patients with cerebrovascular diseases, dementia and delirium have a higher incidence of dehydration (Albert et al, 1989;Holstein et al, 1994;Inouye et al, 1999). Total body water declines with age (Pfeil et al, 1995;, and this decline could also be considered as a risk factor for dehydration.…”

Delirium in the Cardiac Intensive Care Unit

“…Nonpharmacological methods of prevention focus on minimizing the disorienting aspects of hospital care and are proven to reduce delirium in the non‐ICU setting 39. Several studies have demonstrated that implementing a multicomponent structured approach to reorientation including: the use of clocks and calendars; daily reminders to the patient on date, time, place, and reason for hospitalization; sleep preservation by avoiding late night medication administration; early mobilization from bed; early urinary catheter removal; and use of home hearing aids and glasses may reduce the incidence and duration of delirium compared with usual care 40, 41. Unfortunately, to our knowledge, no data have reported on how often such reorientation strategies are performed in the CICU setting.…”

Ten ways to improve the care of elderly patients in the hospital

“…9,10 Multifactorial interventions such as the Hospital Elder Life Project (HELP) have been shown to prevent delirium and falls. [11][12][13][14] Studies of the HELP intervention demonstrated benefits on outcomes that are important to hospitalists, including shortened length of stay. 10,15 While implementing these interventions is not possible at every institution, it may be possible to implement some aspects in a targeted fashion (for example, early physical therapy and mobilization to decrease risk of delirium and falls) or to work with hospital administration to implement the larger interventions.…”

“…44 A landmark randomized controlled trial by Sharon Inouye et al showed that delirium can often be prevented in high-risk patients by ensuring frequent reorientation, maintenance of the patient's usual sleep-wake cycle, early mobilization, adequate nutrition and hydration, and regular use of sensory aids such as glasses and hearing aids. 11 When delirium does occur despite preventive efforts, it should trigger a thorough investigation for an underlying cause. Common contributing factors to delirium in hospitalized patients include infections such as urinary tract infections or hospital-acquired pneumonia, pain, electrolyte abnormalities, cardiac ischemia, medication side effects, and urinary retention or constipation.…”