A condition called delirium is the number one hospital-acquired complication in Australia and can easily be confused with dementia.
To help address the condition, a world-first pilot study has tested an online toolkit called PREDICT (Prevention and Early Delirium Identification Carer Toolkit) for assessing delirium, with positive results.
PREDICT gives family carers a key role in the management of loved ones affected by the confused mental state.
The lead investigator Dr Christina Aggar, Associate Professor of Nursing at Southern Cross University and Conjoint Northern NSW Local Health District, said the PREDICT toolkit helped family carers to recognise and understand delirium.
“Delirium is the number one hospital-acquired complication in Australia, costing our healthcare system more than a billion dollars a year,” Dr Aggar said. “The emotional and financial toll to the patient and the carer is also extremely significant.
“If a healthcare professional doesn’t know the patient, it can be difficult to tell the difference between delirium and dementia. This is why carers are well-placed to recognise subtle changes indicative of delirium and why we’ve involved them in the pilot.”
The new Australian-led international research, involves Southern Cross University, the University of the Sunshine Coast, the University of Saskatchewan (Canada), the University of Canberra and the Northern NSW Local Health District.
The pilot, conducted at The Tweed Hospital on the NSW North Coast, evaluated the effectiveness of PREDICT to support partnerships between carers and nurses to prevent and manage delirium.
Delirium is “frightening” for elderly people experiencing it and alarming for carers attempting to support them.
“Manifesting as a sudden decline in a person’s usual mental function, delirium is a stress-response usually caused by a number of underlying acute, short-term illnesses and medical complications, for example UTI (urinary tract infection), pneumonia or post-surgery,” Dr Aggar said.
“It is often mistaken for dementia because both conditions have similar symptoms, such as confusion, agitation and delusions. However, unlike dementia, delirium comes on very quickly and is potentially reversible.”
Dr Alison Craswell from the University of the Sunshine Coast said collaboration ensured the robustness of the toolkit.
“This project has brought together a team of experts working with lived experience consumers, who have all cared for others, to make sure the toolkit is fit for purpose,” Dr Craswell said.
“The collaboration with our colleagues in Canada has ensured the research has an international reach. This has led to successful Canadian funding to pilot the toolkit in Saskatchewan province with Dr Roslyn Compton and the Better LTC team of researchers and family partners.”
Dr Kasia Bail, Professor of Gerontological Nursing at the University of Canberra, said the use of PREDICT proved life-changing for carers.
“In this research pilot, in addition to the earlier work we’ve been conducting with Associate Professor Aggar’s team, we found that carer knowledge about delirium increased, and that carers wanted to be involved in delirium prevention and management,” Dr Bail said.
“This shows us that the next step in implementing change into the hospital environment needs to be working closely with carers, to support their access to information and partnership with clinicians.
“This research aims to empower carers and potentially reduce further complications such as increased length of stay, functional and cognitive decline, and avoidable admissions to residential care. We’d like to make this common complication less common, and less dire than it can be.”
The next step for the research team is to secure funding to develop a larger trial at hospitals around the country.
The research is published in the Journal of General Internal Medicine.
