S2: Episode 24- Delirium and Sundowning

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare

Guest- Favorite Retired Hospice Nurse Gerard Soucy, RN, CHPN

- BOSTON based

- Previously on Season 1 EPISODE 19 https://open.spotify.com/show/2u3BXV3MNZBzhGPaQftlDs

- BONUS EPISODE 36 https://open.spotify.com/show/2u3BXV3MNZBzhGPaQftlDs

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. ​Story (theme) Family Caregiver/Daughter reported to the hospice nurse that her mother is “sundowning.” Sundowning = DELIRIUM is cyclic, waxes & wanes and is REVERSIBLE. Can happen in different settings. Confusion Assessment method for the ICU (CAM-ICU) https://www.icudelirium.org/medical-professionals/delirium/monitoring-delirium-in-the-icu

1. ​Educate -Teaching points

- Fast Fact #1 Diagnosis and Treatment of Terminal Delirium | Palliative Care Network of Wisconsin https://www.mypcnow.org/fast-fact/diagnosis-and-treatment-of-terminal-delirium/

- New nurses advice: expect, prevent, manage environment, instruct family

- Caregivers advice: Manage environment

- Risk factors: illness, disrupted routine, sensory deprived (glasses, hearing aids), sleep disturbance, substance withdrawal, UNtreated PAIN

- Nurse Gerards tips: step in early, prevention is the best treatment

- Sedate or fix problem, AVOID disinhibiting benzodiazepines

- Hospice Comfort kits have haloperidol, an antipsychotic for terminal delirium. Consider as recommendation in delirium SBAR

Assessment tools

-RASS like temperature calm restless agitated very agitated combative ….use same language ; Richmond Agitation-Sedation Scale (RASS) https://www.mdcalc.com/calc/1872/richmond-agitation-sedation-scale-rass

-Nursing Delirium Screening Scale (Nu-DESC) quick can be done from door https://www.jpsmjournal.com/article/S0885-3924(05)00053-9/fulltext 

1. ​Empower -A valuable a resource

“Delirium in Advanced Disease” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600115/

Website info https://mourningdovemedical.com

Video podcast 🔗 https://youtu.be/3ZFXYcZqVhQ?si=CtJ4LJg1bUU_R7gg #hapc #EducateAndEmpower #PeaceOfMind #TheRealDealAboutHospice #Hope #Delirium #Confusion #Agitation #Disoriented #Restlessness #Anxiety