Episode description

Delirium is associated with an increased risk of falls, dementia and high dependency care, and all of this adds up to higher mortality. About a third of patients admitted to ICU or approaching the end of life experience delirium. But it’s notoriously underdiagnosed, so in this episode we talk about the presentations and detection of delirium. We also go through some of the medical risk factors, including dementia, infection and metabolic disorders like hypercalcaemia. But even more common than these precipitants, are a host of drugs that can alter cognition or increase agitation by their anti-cholinergic properties. Importantly, we also hear Adam Kwok described his experience as the carer of a patient going through the trauma of three bouts of delirium, and the challenges of care. Go to the next episode to hear about non-pharmacological management of those at risk of delirium, and the many caveats of psychotropic medication.

Guests
Adam Kwok
 Professor Meera Agar FRACP FAChPM (Liverpool Hospital, UTS) 
 Professor Gideon Caplan FRACP (Director of Geriatric Medicine, Prince of Wales Hospital, UNSW) 

Production
Written and produced by Mic Cavazzini. Music courtesy of Free Music Archive includes ‘Noir’ by Daniel James Dolby, ‘You Are Not Alone’ by Borrtex, ‘Remember the Archer’ by Scott Holmes, ‘Cherry Blossom’ by Daddy Scrabble and ‘Listen, Lisbon’ by Loch Lomond. Picture licenced from Getty Images. 

Editorial feedback for this episode was kindly provided by members of the RACP’s Podcast Editorial Group; Sern Wei Yeoh, Seema Radhakrishnan, Phillipa Wormald, Duncan Austin, Joseph Lee, Adrienne Torda,  Marion Leighton, Oliver Dillon, Atif Slim, Andrew Whyte, Rhiannon Mellor.

Please visit the RACP website for a transcript embedded with citations. Fellows of the College can claim CPD credits for listening and additional reading.