The best-supported way to prevent delirium in older inpatients is a multicomponent approach delivered every day: orientation, early mobilisation, sleep protection, hearing aids and glasses in use, hydration and nutrition, avoidance of unnecessary catheters, and review of deliriogenic drugs such as anticholinergics, benzodiazepines and sedating antihistamines.
No drug has been shown to prevent delirium reliably in medical inpatients. Antipsychotics are not a prevention strategy, and sedatives given for night-time agitation often make it worse.
- Check that glasses and hearing aids are on and working every morning.
- Mobilise early and protect night-time sleep from avoidable observations and noise.
- Review anticholinergic, benzodiazepine and sedating antihistamine prescriptions on admission.
- Remove urinary catheters and lines that are no longer needed.
Why it matters
The measures that work are simple and often skipped because they belong to no single team.
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