Delirium is characterised by fluctuating changes in cognitive function and occurs most often in older adults. When a person has delirium, they may be confused, agitated or even quiet and drowsy.

Delirium is often caused by a number of factors including infection, constipation, dehydration, malnutrition, pain and medication changes. Delirium is often distressing for the resident, their family and carers, while having a negative consequence on health.

Recent studies show that nutrition plays an important role in the prevention of delirium. Poor food and fluid intake are risk factors for delirium. Therefore, maintaining adequate nutrition and hydration is key to preventing delirium. 

Providing tailored dietary and mealtime strategies for residents, and particularly those with cognitive impairment, can significantly reduce the risk of delirium. Some evidence-based strategies which you can consider include: 

• Encouraging residents to attend dining rooms for meals. 
• Mealtimes are a great opportunity for social connection and interaction. They can also provide stimulation for those residents who are cognitively impaired and may not eat when alone in their rooms. Mealtimes can also provide routine and modelling eating behaviour.
• Providing opportunities for a shared dining room experience. 
• Take the time to consider the dining room environment and make it appealing for residents to visit. Provide opportunities for family members to share mealtimes with their loved ones. This can assist to normalise the mealtime experience and often results in increased nutritional intake. 
• Allowing adequate preparation prior to meals.
• This may include giving the resident medications for pain or nausea, encouraging toileting and positioning the resident appropriately for their meal before it is served.
• Providing a variety of food choices and the opportunity for residents to change their minds at the point of service
• It is important for residents to be involved in the meal selection process, and to be
• provided a variety of food choices in line with their food preferences.
• Consider offering alternate meals if the meal provided is declined or less than 50% is eaten.
• Providing staff assistance at meals. 
• Staff are well placed to provide encouragement and prompting to residents to improve their consumption of food and fluids at mealtimes.
• Encourage resident independence with eating and drinking, but support them by providing assistance as required.
• Monitoring food and fluid intake at every meal. 
• This allows for early identification of poor oral intake and timely referral to the healthcare team for individualised care plans to improve oral intake. 
• Having a variety of food and drinks available outside of regular meal times. 
• It is common for residents with delirium to miss meals as they are asleep or too unsettled or disorientated to complete their meals. Additional food and drinks at times other than at mealtimes allows these residents to catch up on their missed meal once they are feeling more awake and/or settled. 

Incorporating evidence based dietary interventions into care plans is an essential component of delirium prevention and overall promotion of health. By prioritising nutrition, healthcare providers can empower residents to have an enhanced quality of life. 

For further guidance with implementation of nutrition strategies for delirium prevention, please do not hesitate to reach out to the Food Solutions team. Together, we can make a positive impact on the health and wellbeing being of our residents.