Some top tips for nurses who may see a person with a mental health issue include:  

• Starting the conversation. Older people tell us they want to be asked how they are feeling and find talking useful.    
• Trying to get into the habit of asking about the emotional wellbeing of the people you see. 
• Looking out for signs that the people you are seeing may be experiencing mental health issues.
• Thinking about language. Older people can be put off by terms such as ‘mental health’ and ‘depression’. Try to use more informal language. 
• Remembering that mental health issues in later life are not inevitable. With the right support, older people can recover. 
• Being aware of mental health as a health issue and recognising the negative health effects of mental illness.
• Knowing the risk factors which can lead to mental illness.
• Assessing for potential mental health issues. Schedule longer or more frequent visits where possible.
• Developing a resource/referral package that includes social and community organisations.
• Treating underlying medical problems while initiating interventions to address mental health issues.
• Understanding the need for a sensitive and person-centred/holistic approach.

Delirium is a state of heightened mental confusion that commonly affects older people admitted to hospital. The prevalence of delirium is 14 per cent in people over 85.  In nursing homes or post-acute care settings, this figure can be up to 60 per cent.

When older people with dementia experience severe illness or trauma such as a hip fracture they are more at risk of delirium.

Delirium causes great distress to patients, families and carers and has potentially serious consequences, such as increased likelihood of admission to long-term care and increased mortality.

People who have delirium may need to stay longer in hospital or in critical care. They may have an increased incidence of dementia and have more hospital-acquired complications, such as falls and pressure ulcers.

• Alzheimer's Society. Delirium
• British Geriatrics Society. Delirium
• NHS inform. Delirium. NHS inform is Scotland’s national information service.
• National Institute for Health and Care Excellence (NICE). Delirium: prevention, diagnosis and management. This guideline covers diagnosing and treating delirium in people aged 18 and over in hospital and in long-term residential care or a nursing home. It also covers identifying people at risk of developing delirium in these settings and preventing onset. It aims to improve diagnosis of delirium and reduce hospital stays and complications.
• NICE. Recognising and preventing delirium. A quick guide for care home managers. 
• Royal College of Psychiatrists. Delirium. This information is for anyone who has experienced delirium, knows someone with delirium or is looking after people with delirium.
• SIGN (2019). Risk reduction and management of delirium. This guideline provides recommendations based on current evidence for best practice in the detection, assessment, treatment and follow up of adults with delirium, as well as reducing the risk of delirium.