Minimise use of antipsychotic medications Consider one-to-one nursing care, for example for patients at high risk of falls.Avoid using indwelling catheters as they are a source of infection.Consider relaxation techniques, music or massage (this may also help with sleep).Ensure dentures are well fitted and worn.Encourage and help patients with eating and drinking to reduce the risk of constipation, dehydration and under-nutrition.Optimise nutrition, hydration and regular continence For patients unable to walk – encourage them to do in-bed (range of motion) exercise.For patients who use a walking aid - make sure it is accessible and that they use it.Encourage movement - to reduce the risk of experiencing falls, developing pressure areas, constipation and incontinence, and to promote normal sleep patterns.Encourage independence in activities of daily living and minimise risk of falls.Encourage the family, carer and friends to be involved in patient care or to visit (if this is calming to the patient).Discourage daytime napping to aid night-time sleep.Reduce environmental stimuli and invasive procedures to a minimum.Promote cognitive stimulation, for example, talk about news or reminisce.Have large-font clock, calendars and signage on the ward.Provide orientation and reassurance - remind the person where they are, who you are and what time it is.

“If we know the name of their football team or their granddaughter’s name it can help calm them – it doesn’t always work, but when it does work it’s really, really good.” (Nurse, Northern Health) Minimise the patient’s confusion

Introduce the TOP5 Initiative, to encourage staff to:.

Use a tool such as ‘This is me’, which has been adapted by some Victorian Hospitals and introduced as ‘A key to me’ or ‘About me’ to help reduce the older person’s agitation and improve their orientation and experience.

Explain the risk factors, what delirium is, the simple strategies that can prevent or manage delirium and how they can work with staff.

Give patients, their family and carers clear information about delirium.

Address reversible causes, such as impacted earwax.

Address sensory impairment – help patients wear their hearing and visual aids and check they are in good working order.

Communicate effectively – use short sentences and ask single questions use interpreters and liaison staff.

Communicate clearly and address sensory impairment There are many things we can do to help older people and their families and carers understand, prevent and manage delirium.

Delirium audio book