Psych CASC / OSCE · Old age psychiatry — delirium and acute cognitive syndromes
Explain delirium in an older adult to family — CASC communication station
MRCPsych/FRANZCP-style communication station: explain geriatric delirium, CAM-informed thinking, cause treatment and multicomponent care, avoid benzos, cautious low-dose AP only if needed, and prognosis.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the medical ward. [1]
Candidate instructions. Explain delirium in plain language; address fear that this is permanent dementia or "going mad"; outline medical cause treatment and non-drug ward care; explain why benzodiazepines are being avoided/stopped; discuss that antipsychotics are only for severe distress or danger and do not cure delirium; outline recovery timeline and safety planning; check understanding. Examiner plays the daughter. [1][3]
References5ShowHide
- [1]Marcantonio ER Delirium in Hospitalized Older Adults N Engl J Med, 2017.PMID 29020579
- [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]Oh ES, Fong TG, Hshieh TT, et al. Delirium in Older Persons: Advances in Diagnosis and Treatment JAMA, 2017.PMID 28973626
- [4]Witlox J, Eurelings LS, de Jonghe JF, et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis JAMA, 2010.PMID 20664045
- [5]Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium Ann Intern Med, 1990.PMID 2240918