Teaching Presentations

for use with

Integrating a Palliative Approach:
ESSENTIALS FOR PERSONAL SUPPORT WORKERS

by Katherine Murray, RN, BSN, CHPCA(C), FT

Life and Death Matters©
Illustrations by Joanne Thomson©
Chapter 4 H
Delirium
Learning Outcomes
1. Understand why delirium is common in dying
people and identify effects of delirium on mental
abilities.
2. Gather appropriate information on delirium, record
and report.
3. Provide support and comfort to the person and
family when delirium begins, during and afterwards.
4. Identify differences between delirium and
dementia.
What does delirium feel like?

Text pp. 77, 78

Definition of delirium
“…a physical state
when the brain cannot
send or receive
information
correctly…”
Gathering Information
Observing
People with delirium show sudden changes
in their mental processes, affecting their:

Focus

Communication

Decision making

Remembering

Reasoning

Sleeping
Observing We just can’t
keep up with him. He is
getting into everything.
He doesn’t make sense.
He does not seem to
know what he is trying to
do. And he is not
sleeping.
Asking questions
You may not be able to get
answers from the person
Therefore:

Ask the family for
information

Rely on your observations
Adapt Confusion Assessment Method
questions to address:
1. Mental processing
2. Level of attention
3. Speech and language skills
4. Level of consciousness
Text pp. 79, 80
Delirium or dementia?
What are the differences?

Delirium Dementia
?? ??

Text p. 80
Comfort Measures
Preventive
= minimizing the development of severe
delirium

Text p. 81
Preventive

Be alert for signs of delirium

Keep things familiar, quiet and
safe for the person

Maintain their routine if possible

Offer liquids often when receiving
opioids
Preventive
Record and report

Possible early signs of
delirium

Traumatic themes that may
emerge in dreams

Text p. 81
During

Personal safety

Emotional security

Text pp. 81, 82

During

Appropriate
communication

Orientation to reality

Reassurance
Text pp. 81, 82
During

Provide support during
hallucinations

Arrange for spiritual
support

Coach through
relaxation
Text pp. 81, 82
When delirium stops

Reassurance is
important
For the family

Reassurance is
important
Medications and Treatments
Medications can help manage symptoms
Person’s goals of care will direct team

Text p. 84
Summary
1. Understand why delirium is common in dying
people and identify effects of delirium on mental
abilities.
2. Gather appropriate information on delirium, record
and report.
3. Provide support and comfort to the person and
family when delirium begins, during and afterwards.
4. Identify differences between delirium and
dementia.
Questions
For more information
Visit www.lifeanddeathmatters.ca

Contact Kath at kath@lifeanddeathmatters.ca

Powerpoint™ Teaching Presentations to be used in conjunction with the text and workbook
“Integrating a Palliative Approach: Essentials for Personal Support Workers.”
Publisher: Life and Death Matters, 2014 All Rights Reserved©