An older adult admitted to hospital with a urinary tract infection suddenly becomes fearful, irritable and fails to recognise their lifelong spouse. Their confusion and distress alarm loved ones, and concern hospital staff.
While this scenario may look like – and is often mistaken for – dementia, it may in fact be delirium, one of the leading hospital-acquired complications in Australia.
Southern Cross University, in conjunction with the Northern NSW Local Health District (NNSWLHD), is developing an innovative, easy-to-use model of care known as PREDICT – Prevention & Early Delirium Identification Carer Toolkit.
PREDICT is a co-designed model that empowers carers and nurses to prevent delirium and respond to early signs. Early recognition is crucial for improving patient outcomes and could save the Australian healthcare system millions of dollars each year.
The multimedia PREDICT toolkit – available online, via smartphone or in paper format – will be trialled over the next 12 months. All adults aged over 65 admitted to medical wards and selected surgical wards at Tweed Valley Hospital and Lismore Base Hospital will be invited to participate.
The launch of the PREDICT clinical trial coincides with World Delirium Awareness Day on Wednesday, March 11, 2026, an annual event aimed at raising awareness about delirium and its impact on patients, families and healthcare systems, as well as highlighting the latest research and best practice.
PREDICT is designed to help family members and carers prevent, identify early signs of, and better understand delirium. It supports carers to communicate behavioural changes to nurses and work collaboratively to manage delirium in hospital settings.
Southern Cross University’s Professor Christina Aggar is leading the project, supported by a $1.34 million grant from the National Health and Medical Research Council (NHMRC).
The three-year study will involve more than 2500 patients in hospitals across NSW, the ACT and Queensland. It aims to reduce the incidence of delirium and associated hospital costs, and ultimately drive systemic change in delirium management.
“Delirium can be very serious and stressful for the carers, family and health care workers as well as the person who acquires it,” said Professor Christina Aggar.
“It is a stress-response while a person is in hospital, usually caused by a number of underlying acute, short-term illnesses and medical complications, for example infection, pain, surgery or changes in the environment. It is often mistaken for dementia because both conditions have similar symptoms, such as confusion, agitation and delusions. However, unlike dementia, delirium comes on very quickly and is potentially reversible.”
Professor Aggar said carers played an important role alongside clinical staff in preventing and recognising the onset of delirium.
“Carers can detect subtle changes in the health and behaviour of a patient that health professionals may miss, for example a nurse who has never met the person before might not realise the patient doesn’t always behave in such an erratic way,” said Professor Aggar.
“Carers involved in the pilot research conducted at The Tweed Hospital in 2023-2024 reported a significant increase in delirium knowledge, enabling them to more effectively support loved ones. PREDICT helped carers understand delirium, strengthen carer-nurse partnerships, and improved risk identification and early intervention.”
Northern NSW Local Health District Director of Nursing and Midwifery Katharine Duffy said it was exciting to see the project progress to clinical trial.
“Northern NSW is home to a significant aging population, with one in four people in the region expected to be aged 70 years or older by 2041,” Ms Duffy said.
“And we know 50 per cent of patients aged over 65 years are at risk of delirium while hospitalised, so the importance of this project cannot be overstated.
“We are excited to have been involved in this innovative research project since it was successfully piloted in our hospitals in 2023-24. Delirium is a serious condition and anything we can do to better manage it will lead to improved outcomes not only for our patients and their families and carers but also for our staff.”
What is delirium?
Delirium is a sudden, temporary and severe state of confusion, characterised by disturbances in attention, awareness and cognition that develop over hours or days. It can occur while a person is in hospital.
Delirium is often misdiagnosed in older adults as dementia. Unlike dementia, which is typically chronic and progressive, delirium is acute and usually temporary. Early recognition is crucial for better patient outcomes.
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