Grant: Operating Grant

Delirium is a sudden, usually temporary condition that affects the normal functioning of the brain. It is characterized by a disturbance in consciousness, attention, orientation, memory, thought, perception and behaviour. It is a common and serious problem among older people admitted to hospital or a nursing home. Consequences for elderly patients who develop delirium include decline in functional autonomy, cognitive deficits, prolonged hospital stay and even death. Despite its importance, delirium is often missed by nurses. This is a serious concern because early recognition of delirious patients is essential for both prompt management of the underlying causes of the delirium and rapid implementation of intervention aimed at reducing its severity and duration. Our team has been working on the development of a new screening instrument to address the issue of barriers to the recognition of delirium. We call this instrument RADAR. It is quick to administer, suitable for use by both nurses and nurse assistants, can be integrated into routine care, is suitable for use among patients with or without dementia and is suitable for use in hospitals and nursing homes. These characteristics enable a continuous and frequent assessment of signs of delirium which is essential given the fluctuating nature of delirium throughout the course of a day. This is also achieved without significant increase in nursing staff workload. Our team undertook a pilot test of RADAR among 57 older persons and in so doing, demonstrated that the proposed study design is feasible in both hospitals and nursing homes. The use of the RADAR in these settings was positively received by the participating nursing staff and preliminary information on the properties of RADAR has yielded positive results. The objective of the proposed project is to further develop and validate RADAR by applying the methodology used for the pilot study in a large-scale study.