An older adult in hospital for a urinary tract infection suddenly becomes fearful, irritable and doesn’t recognise their lifelong spouse. Their confusion and distress are frightening for loved ones and hospital staff are concerned. While this scenario looks – and is often mistaken as – dementia, what’s unfolding is delirium.
Delirium is one of the leading hospital-acquired health complications in Australia.
Southern Cross University, in conjunction with Northern NSW Local Health District (NNSWLHD), is leading the development of an innovative, easy-to-use model of care, known as PREDICT – Prevention & Early Delirium Identification Carer Toolkit.
PREDICT is a co-designed model of care that empowers carers and nurses to prevent and respond to early signs of delirium. Early recognition is crucial for better patient outcomes and can potentially save the Australian healthcare system millions of dollars annually.
The multimedia PREDICT toolkit (web, smart phone or paper-based) will be trialled over the next 12 months, when all adults aged over 65 years admitted to medical wards and some surgical wards in the Tweed Valley and Lismore Base hospitals will be invited to engage with PREDICT.
Raising awareness
Launch of the PREDICT clinical trial aligns with World Delirium Awareness Day, happening this week, an annual event to raise awareness about delirium and its impact on patients, families, and healthcare systems, along with the latest research and best practice.
PREDICT is designed to assist and support family members and carers to prevent, identify early, and understand delirium. It helps carers communicate changes in a patient’s behaviour to nurses, and work as a team to manage delirium in hospital settings.
Professor Christina Aggar of Southern Cross University is leading the project which has the backing of a $1.34 million grant from the National Health and Medical Research Council (NHMRC).
The three-year research study, involving more than 2500 patients in hospitals in NSW, ACT and Qld, aims to reduce the incidence of delirium and associated hospital costs and ultimately drive systemic change in delirium management.
‘Delirium can be very serious and stressful for the carers, family and health care workers as well as the person who acquires it,’ said Professor Christina Aggar.
‘It is a stress-response while a person is in hospital, usually caused by a number of underlying acute, short-term illnesses and medical complications, for example infection, pain, surgery or changes in the environment. 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.’
Carers crucial
Professor Aggar said carers played an important role alongside clinical staff in preventing and recognising the onset of delirium.
‘Carers can detect subtle changes in the health and behaviour of a patient that health professionals may miss, for example a nurse who has never met the person before might not realise the patient doesn’t always behave in such an erratic way,’ said Professor Aggar.
‘Carers involved in the pilot research conducted at The Tweed Hospital in 2023-2024 reported a significant increase in delirium knowledge, enabling them to more effectively support loved ones.
‘PREDICT helped carers understand delirium, strengthen carer-nurse partnerships, and improved risk identification and early intervention.’
Northern NSW Local Health District Director Nursing and Midwifery Katharine Duffy said it was exciting to see this project proceed to clinical trial.
‘Northern NSW is home to a significant aging population, with one in four people in the region expected to be aged 70 years or older by 2041,’ Ms Duffy said. ‘And we know 50 per cent of patients aged over 65 years are at risk of delirium while hospitalised, so the importance of this project cannot be overstated.
‘We are excited to have been involved in this innovative research project since it was successfully piloted in our hospitals in 2023-24. Delirium is a serious condition and anything we can do to better manage it will lead to improved outcomes not only for our patients and their families and carers but also for our staff.’
You can keep up to date with the PREDICT project here.
Check out this short video showing the PREDICT toolkit in action:
2 Comments
I think UTIs often go undetected in Aged Care facilities. Early detection would be an invaluable tool for the staff and for the residents.
For anyone who has ever cared for an elderly relative or worked in aged care the very first step would be a urine test. So often the cause is simply a urinary tract infection which is easily treated if acted on promptly.