Question 1

One of the roles of the registered nurse in an aged care environment is to reduce the risks of harm to an older person. An older person is at a higher risk of developing delirium. Discuss two (2) associated risk factors of delirium.

Describe strategies that could be implemented to minimise the associated risks.

Delirium is a disorder in mental abilities which results in perplexed thinking and lack of awareness of the surroundings. It happens in a usually rapid state- within a few hours or days. It is most common in elderly adults. If not taken care of properly, it can result in factors that can harm the elder’s people ( Eske, 2019). Delirium is the situation where elderly peoples are the ones who are most affected. This happens in them because their brain become resilient which can had severe memory loss and even can lead to a situation of hospitalization. Various factors can increase the risk of delirium. Some are intrinsic factors like age, chronic illness, sensory impairment(Dylan, 2019). Some are extrinsic factors like infectious, Metabolic, and many more. Some of the factors are discussed under:  

• Brain disorders like dementia, Parkinson’s disease: If a person is not taken care of properly in the initial stage of Delirium, he/she become more prone to dementia (Mayoclinic, 2020). Dementia is similar to Delirium, where a person tends to lose his/her memory (Cleveland Clinic, 2020). It is a chronic disease and gradually worsens over time.
• Sensory Impairment: Sensory Impairment happens when one of the senses is no longer normal. There is a strong association of visual and hearing impairment with delirium. Vision and hearing may be lost or a person can have difficulty when a person is suffering from Delirium. Also, it can result in dehydration due to which urinary tract infections can be there because of which patients are afraid to drink (Morandi, et al., 2021).
• Polypharmacy can also be a risk factor as overprescribing medications can also pose a threat to health. Proper dosage should be taken, as excess intake of medicines can drastically affect people minds and behaviour (Hein, et al., 2014).

Preventive Measures To Minimize Associated Risks:

For minimizing the occurrence of delirium, prevention is the most effective strategy. Drugs named benzodiazepines or anticholinergics should be avoided (Korc-Grodzicki et al., 2015).

Clear communication and addressing sensory impairment help to minimize delirium risk. Use tool named “This is me” should be used as it helps to reduce older person agitation and improves experience (Dylan, 2019). Using short sentences and asking single questions also help in minimizing confusion thus helping in the improvement of delirium. Besides this, they should be given priority in minimizing their confusion by avoiding any room change. They should regularly be reminded about where they are, what time it is. Certain Strategies like promoting good sleeping habits, sufficient light, good nutrition and maximum hydration can help a lot in reducing the severity of delirium (Brusie, 2018). For minimizing dehydration fluid balance chart, monitoring for UTI must be undertaken. Also, instead of taking over excessive doses of medicines, it is better to take pharmacist advice.