Delirium
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STEP 3: Institute routine multi-component non-
pharmacologic delirium prevention strategies
➤ The Hospital Elder Life Program (HELP) was originally designed to
prevent delirium among hospitalized older persons by keeping them
oriented to their surroundings, meeting their needs for nutrition,
fluids, and sleep and keeping them mobile within the limitations of
their physical condition.
• The program prevents delirium (incidence of delirium [OR 0.47, 95% CI 0.35-
0.95])
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• It also reduces the rate of falls (OR 0.58, 95% CI 0.35-0.95)
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• It has been adapted for use in PALTC
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Table 3. Medications Commonly Associated with Delirium
• Central acting agents:
▶ Sedative hypnotics (e.g. benzodiazepines)
▶ Anticonvulsants (e.g. barbiturates)
• Analgesics: Narcotics (e.g. meperidine)
• Antihistamines (e.g. hydroxyzine, diphenhydramine)
• Antispasmodics (e.g. oxybutynin)
• Gastrointestinal agents:
▶ Antispasmodics (e.g. dicyclomine)
▶ H2-blockers
• Antiemetic: (e.g. scopolamine, chlorpheniramine)
• Antibiotics:
▶ Fluoroquinolones
• Psychotropic medications:
▶ Tricyclic antidepressants (e.g. amitriptyline)
• Miscellaneous:
▶ Skeletal muscle relaxants (e.g. cyclobenzaprine)
▶ Corticosteroids
