Table 3 GMU Core interventions
From: A New Model of Delirium Care in the Acute Geriatric Setting: Geriatric Monitoring Unit
1. | No mechanical restraints and where possible, no pharmacological restraints. After trying all non-pharmacological methods and patient proves to be a danger to himself and others, then antipsychotics and sedative-hypnotics are used carefully at the lowest possible dose and to tail down the dose and remove the pharmacological agent once not required. |
2. | Thrice daily patient orientation via reality orientation board |
3. | Early mobilization with the help of therapists and trained nurses |
4. | Provision of visual aids (such as eye glasses) if available |
5. | Providing adequate hearing aids/earwax disimpaction where necessary with the use of portable audio amplifier |
6. | Oral volume repletion/feeding assistance with scheduled oral intake schedule |
7. | Sleep enhancement using non-pharmacological sleep protocol of warm milk, relaxation tapes or music. Sedative-hypnotic agents will again be the last line management. |
8. | Bright light therapy from 6-10 pm |
9. | Thrice daily therapeutic activities program for cognitive stimulation and socialization |
10. | Minimizing immobilizing equipments like intravenous drip, urinary catheter, oxygen tubing |
11. | Daily visitor program by family to encourage communication and social support |
12. | Pain management |