The Pinch Me Pod - an MDT approach to delirium in hospital settings

In this sixth (and final) episode, we think about what happens when someone with delirium in the acute hospital setting is approaching the point where they no longer need to remain an inpatient. What factors needs considered? What are the different options for where these patients could go to after hospital? What if the delirium hasn’t fully resolved prior to them leaving hospital? Does that affect the decision on where the most suitable place might be for them?
As you can see, there are lots of issues to tackle relating to discharge from hospital, so that’s why we’ve chosen to spend this final episode looking at this in detail. Our group of expert voices, all of whom provide care for patients with delirium on a daily basis, will share from their own experiences and offer advice on how best to manage complex cases, and remind us of the main things not to forget when drawing up plans for these patients as they prepare for life outside the hospital setting.
Once again, if you have any feedback, please complete this short questionnaire - https://forms.microsoft.com/e/5MH4nCSNH1 
Any thoughts on how you have found the series would be greatly appreciated.
Thanks once again for your time and we really hope you’ve enjoyed listening as much as we’ve enjoyed recording the episodes and piecing them together for you. Keep up the great work you all do in looking after patients and families affected by delirium, and we trust this resource will continue to be of benefit to you and your colleagues in the future. Goodbye from us all!

In this Fifth episode, we discuss the importance of communicatng about delirium well with the families of patients affected by it. It’s a worrying sight for families to witness their loved ones becoming acutely confused due to the causes we’ve mentioned in previous episodes, and it takes a structured, compassionate approach to explain to family members why a delirium might have come about and what we can try and do as a team to minimise its impact.
We offer tips in this episode for how to place ourselves in the shoes of family members, and use our interactions with them to gain information about patients as well as offering calm reassurance when they might be concerned about the effect an acute delirium is having on their loved ones.
This is a crucial aspect of delirium management in the hospital setting, and an area that must not be pushed to the side. If our communication is not caring, dignified and constructive, relationships can break down, and this is something we must look to avoid. We want our patients to receive the best possible holistic care, and we want to help walk their families through the often unsettling journey of an inpatient stay one small step at a time. 
If you’ve enjoyed the episode, please leave us some feedback at https://forms.microsoft.com/e/5MH4nCSNH1
We look forward to sharing with you once again in our next (and final) episode when we will be taking a look at what happens when a patient with delirium is ready to leave the acute hospital setting, and what factors need considered when planning their discharge. See you then!

In this fourth episode, we consider what we can do to try and support patients with complex, difficult and prolonged cases of delirium that don't resolve as quickly or as easily as we would like them to.  We consider the concept that behaviour of any kind is a form of communication that is often driven by a need, and we talk through the benefits of therapeutic interactions, including communication, validation, distraction and reminiscence therapies.   We explore the role of the mental health liaison service and also consider, when all else fails, when it may be appropriate to consider pharmacological interventions.   This series really encourages open and honest conversations in exploring the difficulties that can be encountered in an acute hospital setting as we seek to care for our patients with delirium.  

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We look forward to catching up with you in our next episode when we will be discussing how to communicate about delirium with family members and we hear directly from some families about the impact delirium has had on their loved ones.

In this third episode, we move on to the next step and focus on the management of delirium. How do we look after patients affected by delirium? Can we expect them to make a full recovery? And if so, how long does that process normally take? We recognise that the management of delirium is multifaceted and it is crucial that we aim to identify and treat the underlying causes.  We also dip into some strategies we can put into practice when looking after patients with delirium, such as therapeutic activities, cognitive stimulation, and effective communication skills, as well as exploring the role that medications play.  Finally, our Falls Coordinator briefly highlights the link that there can be between delirium and falls, and how we can reduce the risk of falls in patients with delirium on our wards.

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We look forward to catching up with you in our next episode where we consider complex and prolonged delirium in patients, where symptoms are not easily resolving.

In this second episode, we explore the various triggers for delirium and what causes this acute confusional state, as well as consider some methods for preventing it. 
We consider questions such as can other medical conditions make someone more likely to get delirium and can multi morbidity play a part?  Julie Magee, lead pharmacist, explores the role medications can play in delirium and highlights the importance of a medication review and assessing the anticholinergic burden in patients.  
Finally, we reflect on how promoting the Delirium Care Pathway and the Pinch Me memory aid can help us consider the multiple factors that can cause delirium, and help us make the most of the window of opportunity we have, when someone comes in to hospital, to bring about positive change.  
Feedback would be very welcome by completing this short survey
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We look forward to catching up with you in our next episode where we consider the big topic of how we manage delirium.