Care Strategies for Delirium, Dementia and Depression
An effort has been initiated in this section to weave information
and multi-component care strategies together specific to delirium,
dementia and depression in older adults. This “Kaleidoscope
of Care Strategies” is presented in Figure 1 on page 19 of
the RNAO Best Practice Guideline, Caregiving
Strategies for Older Adults with Delirium, Dementia and Depression.
Not all care strategies are represented, however, it emphasizes
the guiding principle that care is provided to the highest level
of an individual’s ability and that delirium, dementia and/or
depression may co-exist.
Nurses who care for older adults should become familiar with the
care strategies outlined in this document, use the document from
the RNAO (2003) guidelines on Screening
for Delirium, Dementia and Depression in Older Adults and begin
to apply as many of the recommendations as possible in their individual
work settings. The nurses’ role is to assess for all three
conditions within the context of the following tenets of care:
- Know the person
- Relate effectively
- Recognize retained abilities
- Manipulate the environment
Excellence in care requires using best practice assessment (including
screening and ongoing assessments over time), using standardized
instruments, and measuring the outcomes of care. The care of older
adults with delirium, dementia and depression is often complex due
to the number of chronic illnesses (numerous medications, coping
with reduced function), and any acute illness that the client may
have superimposed on these conditions. Practice settings would benefit
from the participation and expertise of advanced practice nurses
for full implementation.
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