Introduction

The barriers to quality delirium care are multifactorial and have only become more pronounced and more numerous in the setting of the COVID-19 pandemic. The primary aim of our symposium entitled ‘Improving Delirium Care in Acute Hospitals: Addressing Old and New Challenges’, is to highlight effective strategies to help overcome these barriers in the acute hospital setting.

We are delighted to have Kara McLoughlin (Occupational Therapist, Beaumont Hospital) and Louise Martin (Physiotherapist, Cork University Hospital) open the symposium with their talk about the important role of the multidisciplinary team in delirium management in the Emergency Department. Dr Niamh O’Regan will then present new national algorithms for delirium care in the acute setting and Dr Paul McElwaine will discuss his experiences in managing delirium throughout the COVID-19 pandemic. Finally, we are very fortunate to have Prof Alasdair MacLullich share his expertise on ‘Developing, Implementing and Sustaining Improvements in Delirium Care’ to close the symposium.

At the end of this symposium, you will have a better understanding of how best to address the challenges to delirium care in your own institution and in your own practice.

Programme

Moderators     Dr Diarmuid O'Shea, Dr Dan Ryan

Welcome and Introduction     Prof Rose Anne Kenny, President of the Irish Gerontological Society

The role of therapy in delirium management in the emergency department     Louise Martin, Kara McLoughlin

Consolidating the assessment and management of delirium in acute care – updated Irish pathways     Niamh O’Regan

Overcoming Challenges in Delirium Care throughout the COVID-19 Pandemic     Dr Paul McElwaine

Developing, implementing and sustaining improvements in delirium care     Prof Alasdair MacLullich, University of Edinburgh

Panel discussion with Q &  A

Participants

Louise Martin is a senior physiotherapist at Cork University Hospital. She completed her MSc in physiotherapy at Robert Gordon University in 2012. She was involved in setting up and implementing the Frailty Intervention Therapy Team (FITT) in the emergency department and AMAU in Cork University Hospital in 2019 and continues to work on this team aimed at improving care for older adults. She sat on the working group for the National Delirium Pathway which aimed at early identification and management of delirium in the acute setting.

Kara Mc Loughlin graduated with a BSc (Hons) in Occupational Therapy from Teesside University in 2012. She worked in the U.K. & New Zealand before returning to Ireland in 2016. She was involved in the setting up of a number of Frail Intervention Therapy Teams before commencing her current role as a Clinical Specialist Occupational Therapist in Care of the Elderly/FITT in Beaumont Hospital. She has taken an active role in prompting Occupational Therapy in Ireland and sat on the management team for the Association of Occupational Therapy. She is currently completing her MSc in Older Persons Rehabilitation at UCC.

Dr Niamh O’Regan is a Consultant Geriatrician in University Hospital Waterford. She completed her higher specialty training through the RCPI in 2015 and was awarded her PhD by University College Cork in 2016. Her PhD focused on the early identification of delirium in older inpatients. She continued this research interest in her role as a Clinician Researcher in Western University, Ontario, before returning to Waterford. She is particularly interested in enhancing knowledge translation in delirium care, through research and quality improvement, and was recently involved in the development of national algorithms for the detection, prevention and management of delirium in acute hospitals.

Dr Paul McElwaine

Dr McElwaine graduated with an honours degree from University College Dublin in 2004.  Paul trained in the disciplines of Geriatric Medicine and General Internal Medicine, completing his specialty training in 2015 and commencing his post as Consultant Physician in Geriatric Medicine in Tallaght University Hospital in 2016.  He is a clinical senior lecturer in the Department of Medical Gerontology, Trinity College Dublin.  He coordinated the national audit of acute and rehabilitation services in stroke in Ireland 2015-2016 in conjunction with the Irish Heart Foundation which formed the basis of his Medical Doctorate. His research interest includes comprehensive geriatric assessment, in particular its impact on falls prevention and neurovascular health.  He is a member of the IGS, ISPGM and the BGS.

Prof Alasdair MacLullich

Following undergraduate medical training at the University of Edinburgh, including an intercalated BSc in Psychology, Alasdair MacLullich completed general medical training and went on to do a PhD on glucocorticoids and cognitive ageing. He was Clinical Lecturer in Geriatric Medicine from 2000-2005 then MRC Clinician Scientist Fellow from 2005-2009, and was appointed Professor of Geriatric Medicine in 2009.  His main research interests are the clinical assessment, neuropsychology, and pathophysiology of delirium. He also has interests in dementia, frailty, and hip fracture research. He is the main author of the 4AT delirium assessment tool. He co-founded the European Delirium Association in 2006 and the Scottish Delirium Association in 2011.  Alasdair MacLullich is active clinically, working in acute geriatric medicine and acute orthogeriatrics. He co-chaired the committee which produced the Scottish Intercollegiate Guidelines Network guidelines on delirium, published in 2019. He is Chair of the Scottish Hip Fracture Audit Steering Group.