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Acute Deterioration in Care Home Residents

News and presentations from today's conference foucsing on delivering outstanding practice in recognising and responding to the deteriorating resident. Chaired by Daniel Hodgkiss, Assistant Programme Manager, West Midlands Academic Health Network.

Recognising Delirium as a Sign of Deterioration and Underlying IllnessDr Madhavi Vindlacheruvu
Dr Madhavi Vindlacheruvu, Consultant Orthogeriatrician, Cambridge University Hospitals NHS Foundation Trust

• spreading the message that delirium is preventable
• key steps you can take to prevent delirium in care home residents
• understanding deterioration and identifying clinical factors contributing to delirium
• delirium prevention and recognition in Covid-19
• case studies

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Madhavi began her presentation by saying we should stop using 'confused' and use 'delirium' as it gives a much broader launchpad to how we can approach things. She said delirium is very common, there are 3 types: hyperactive, hypoactive and mixed.  Hypoactive when someone is withdrawn, sleepy and inactive can be the most dangerous leading to complications such as pressure sores and dehydration.  Delirium is a medical emergency, it has high risk of complications but it is preventable with early identification and management.  Madhavi said it is important to treat the causes of delirium such as good management of infection, hydration, nutrition and constipation. She said it is important to look out for the non verbal signs of pain and improve sleep through exercise and mindfulness.

Concluding her presentation Madhave said: 

  • Delirium is incredibly serious and can lead to mortality 
  • Prevention is best 
  • Treat the underlying causes 
  • Non-pharmacological interventions are better than pharmacological treatments and isolation 
  • Education is vital 
  • Recognised changes in behaviour 


EXTENDED SESSION Identifying Sepsis in Care Home ResidentsDr Ron Daniels BEM
Dr Ron Daniels BEM, Consultant in Anaesthesia and Intensive Care, University Hospitals Birmingham NHS Foundation Trust; Vice President, Global Sepsis Alliance; Executive Director, UK Sepsis; and Senior Lecturer

• supporting and educating frontline care home staff to recognize signs of sepsis
• Sepsis and Covid-19: are Covid-19 survivors more at risk of Sepsis?
• ensuring prompt action
• an update from the UK Sepsis Trust



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