Even though delirium has been known for centuries it is still poorly detected (non-detection rates of 32–67%)5 and is not well understood by many general hospital practitioners. For example, a qualitative study revealed that 75% of general nurses interviewed stated that they did not know the difference between delirium and dementia, even though 75% said that they had had formal education on the topic or had been to a conference about confusion in elderly people.6
Up to 50% of delirium affecting older people develops after admission to hospital (incident cases). These cases often result from hospital-related complications or inadequate care. It has been suggested that delirium is a symptom of how hospital care is failing older people and is a window to improve its quality for the elderly.7
Incident delirium is particularly important in general hospitals because it is acquired in hospital and may be preventable. This paper will focus on the prevention of incident delirium.