Explain delirium in an older adult to family — CASC communication station

Open and agenda-set. Greet; ask main worries first (dementia forever? sedation request). Name time available. [1]

Explain diagnosis. "This is delirium — an acute medical confusion. Attention and awareness go up and down over hours and days because the brain is reacting to illness. It is not the same as Alzheimer disease progressing overnight, and it is not a primary psychiatric illness like schizophrenia. Pneumonia is a common trigger in older people. We confirm it by checking for sudden change, fluctuating course, and problems with attention." [1][5]

Explain treatment. "First we treat the pneumonia and reverse other triggers — pain, constipation, dehydration, medicines that worsen confusion. We also use practical ward measures that work: reorientation, glasses and hearing aids, day-night routine, early walking when safe, family presence, good hydration. These are the proven foundations of care." [2][3]

Explain medicines. "Strong sleeping tablets and benzodiazepines usually make delirium worse, increase falls, and are not treatment for this syndrome unless someone is in alcohol or sedative withdrawal. We are stopping the temazepam carefully if safe. Antipsychotic medicines do not cure delirium. We only consider a low dose for a short time if Mum is severely distressed or unsafe after non-drug measures, with monitoring — not as a routine 'knock-out' drug." [3]

Prognosis and close. "Many people improve as the medical problem improves, but thinking can lag by days to weeks. We will not send her home alone while still unsafe. There is higher risk of later cognitive problems and care needs after delirium, so we plan follow-up." Summarise, teach-back, invite questions, written information, next review. [4][1]