An older adult in hospital for a routine condition suddenly becomes fearful, irritable and unable to recognise loved ones. While this can resemble dementia it is often delirium, a common and serious hospital acquired complication.
Researchers from the University of ÃØÃÜÖ±²¥ and Southern Cross University have developed PREDICT, an easy-to-use, nurse-led model that helps prevent and identify delirium early.
PREDICT (the Prevention & Early Delirium Identification Carer Toolkit) is a co-designed multimedia resource (web, smart phone or paper-based) that empowers carers and nurses to prevent, recognise and respond to early signs of delirium. Early recognition is crucial for better patient outcomes and can potentially save the Australian healthcare system millions of dollars annually.
Partnering with ÃØÃÜÖ±²¥ Health Services, older adults admitted to surgical and medical trial wards at ÃØÃÜÖ±²¥ Hospital, North ÃØÃÜÖ±²¥ Hospital and University of ÃØÃÜÖ±²¥ Hospital will be invited to participate in the trial.
The launch of PREDICT aligns with World Delirium Awareness Day on Wednesday March 11, 2026, an annual event to raise awareness about delirium and its impact on patients, families, and healthcare systems, along with the latest research and best practice.
PREDICT is designed to assist and support family members and carers to prevent, identify early, and understand delirium. It helps carers communicate changes in a patient’s behaviour to nurses and work as a team to manage delirium in hospital settings.
Professor Christina Aggar of Southern Cross University is leading the project which has the backing of a $1.34- million grant from the National Health and Medical Research Council (NHMRC).
The three-year research study, involving more than 2500 patients in hospitals in NSW, ACT and Qld, 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 nurses 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 UTI (urinary tract infection), pneumonia or post-surgery anaesthetic. 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 nursing staff.
“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.
“Carers involved in the pilot research in 2023-2024 reported a significant increase in delirium knowledge, enabling them to more effectively support loved ones. PREDICT helped carers make sense of their predicament, strengthened carer-nurse partnerships, and improved risk identification and early intervention.”
ÃØÃÜÖ±²¥ Health Services spokesperson, Ms Kellie Lang, Executive Director Nursing and Midwifery, says delirium is one of the most distressing experiences a patient and their family can face in hospital.
“Delirium can be hard to identify early. Working in partnership with carers through the PREDICT model will help us recognise changes and intervene quickly,” she said.
“ÃØÃÜÖ±²¥ Health Services is pleased to be working alongside Southern Cross University and the University of ÃØÃÜÖ±²¥ to introduce this model of care into our trial wards. It is the result of the long-term sustained effort to make a difference in cognitive care in hospital.
“This trial reflects our commitment to safe, person-centred care and to supporting families and carers as essential partners in a patient’s recovery,” said Ms Lang.
Professor Kasia Bail from the Centre of Ageing Research and Translation (CARAT) at the University of ÃØÃÜÖ±²¥ has spent the last decade researching delirium and advocating for more awareness of the condition.
“This trial, developed in conjunction with Southern Cross University, has been a longstanding team effort between CHS and UC to improve care of people with cognitive impairment in all settings, and particularly in hospitals,” said Professor Bail.
“Anybody can get delirium, however, it’s most common in older adults in hospital. Delirium is likely to last longer in older people and have more consequences, like other complications and long hospital stays. That's why this program is so important, so we can recognise and reduce the impact of delirium on people most at risk.
“Hospitals can be a bit like a long-haul flight: confined in a restricted space with strangers and limited choices, and this situation, combined with complex illness and medications, can affect brain function. PREDICT will help people stay oriented or identify changes early for safer landings.
“Our UC research team always says ‘cognitive care is everybody's business’. This program is the next intervention in our suite of cognitive care changes we need to improve health workforce interventions and health services,” Professor Bail added.
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 happens while a person is in hospital.
Unfortunately, delirium is often misdiagnosed in older adults as dementia. Unlike dementia, which is usually chronic and progressive, delirium is acute and typically temporary. Early recognition is crucial for better patient outcomes.
Video: PREDICT toolkit helping carers and healthcare professionals to better manage delirium
Keep up to date with the PREDICT project: