SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 20 (October 3, 1997)

This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care. Click here to access the Knowledge Base. Click here to access descriptions of 27 Innovative Models of HIV/AIDS Care and the lessons learned from these projects. SPNS/Fax was written, published, and distributed by fax by The Measurement Group between 1995 and 1998.

Information dissemination from 27 Innovative Models of HIV Care projects funded as Special Projects of National Significance by the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA).

Introduction

Welcome to SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements. In each issue of SPNS/Fax, we will highlight findings from the HRSA Special Projects of National Significance Program Cooperative Agreements. The projects have been funded to develop innovative models of HIV/AIDS care. SPNS/Fax reports are distributed every two weeks by fax machine to all subscribers. All issues of SPNS/Fax are also available at this Web site. Due to slight differences in the media, issues distributed by fax machine may appear slightly different from those posted on this Web site, but the content is identical.

University of Washington Creates Video and Study Guide on AIDS–Related Delirium

The University of Washington produced a video package that gives an overview of delirium and the role it can play in the lives of people with HIV/AIDS. Acknowledging that it is often difficult to recognize delirium and to distinguish it from dementia or major depression, the video and accompanying study guide provide basic information and actual footage of patients. The study guide also provides supplementary information for training facilitators using the videotape to help both HIV/AIDS care providers and the families and friends of HIV/AIDS patients understand AIDS-related delirium. The study guide reiterates many of the points made in the video, and provides more extensive explanations so that the trainer has a broader base from which to facilitate discussion. It follows the same outline as the video and contains a self-test and list of references for further study.

The information in both the video and the study guide is broken down into four categories: (1) Recognizing Delirium; (2) Diagnosing Delirium; (3) Managing Delirium; and (4) Preventing Delirium. Learning objectives for each section are listed below.

Recognizing Delirium

Diagnosing Delirium

Managing Delirium

Preventing Delirium
  • Demonstrate an understanding of the four diagnostic criteria for delirium
  • Identify several factors associated with delirium
  • List three medication categories associated with delirium in HIV/AIDS, and list several medications in each category
  • Demonstrate an understanding of HIV-associated dementia and of major depressive disorder
  • Identify factors that differentiate delirium from HIV-associated dementia and/or major depressive disorder
  • Identify three components of managing delirium, and give examples of each
  • Describe an appropriate pharmacological approach to management of delirium
  • Identify specific medication categories to avoid or minimize when treating delirium
  • Identify five areas of patient care or intervention that may help prevent delirium

Because delirium frequently is confused with other neuropsychiatric illnesses, such as HIV-associated dementia (HAD) and major depressive disorders, the video helps care providers, friends and family members to differentiate between the three illnesses. For example, delirium develops over a short period of time (i.e., hours to days), while HAD and major depressive disorders tend to occur over several weeks. A thorough medical history and a physical and mental status examination are needed to make a clinical diagnosis.

Identifying the cause of delirium is important in managing it. Causes may be simple, such as dehydration, sleep deprivation, or anemia, as well as infections and high fevers. Medication may cause delirium, as well. Thus, behavioral interventions can be used to manage various aspects of delirium which medications cannot fully address.

Preventing delirium may be achieved through the following: careful review of the patient’s medications; non-pharmacotherapy options, such as helping the patient to relax and wind down at bedtime to maximize sleep; reducing risk of trauma by increasing the patient’s physical strength, balance and coordination; and minimizing changes in their environment.

For more information, contact Karina K. Uldall, M.D., M.P.H., Principal Investigator, AIDS Education and Training Center, University of Washington,  901 Boren Ave., Suite 1100, Seattle, WA 98104; 206.221.4944 (phone), 206.221.4945 (fax), e-mail keegan@u.washington.edu.

To view the brochure Unmasking AIDS-Related Delirium, click here.

SPNS/Fax is produced by The Measurement Group–PROTOTYPES Evaluation and Dissemination Center (EDC). Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax).
 

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