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Psych CASC / OSCEConsultation-liaison psychiatry

Psych CASC / OSCE · Consultation-liaison psychiatry

Explaining delirium and the care plan to a family member — CASC communication station

MRCPsych/FRANZCP-style station: explain delirium in plain language, outline medical and non-drug care, limit inappropriate sedatives, and address capacity/finances carefully.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
An 81-year-old woman with pneumonia is fluctuating in confusion. At night she tried to climb out of bed; by day she is drowsy. Her son arrives angry that 'psychiatry has not fixed her brain' and demands sleeping tablets and a CT scan 'for dementia'. He asks whether she is going mad and whether she can still sign her house over to him this week.

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar on the medical ward. The patient is receiving antibiotics for pneumonia and is being nursed with close observation. [1]

Candidate instructions. Explain delirium in plain language, link it to the pneumonia and hospital factors, describe the care plan (treat infection, review medicines, reorientation, avoid unnecessary sedatives), answer questions about "madness" and dementia, and carefully address financial capacity — do not facilitate opportunistic property transfer while she is delirious. [1][2][3]

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References3ShowHide
  1. [1]Marcantonio ER Delirium in Hospitalized Older Adults N Engl J Med, 2017.PMID 29020579
  2. [2]Inouye SK, Bogardus ST Jr, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients N Engl J Med, 1999.PMID 10053175
  3. [3]Oh ES, Fong TG, Hshieh TT, et al. Delirium in Older Persons: Advances in Diagnosis and Treatment JAMA, 2017.PMID 28973626
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