'Just a delirium': a qualitative study of care home managers' perspectives on barriers to delirium recognition and management in UK care homes.

Delirium is a common but frequently under-recognised neuropsychiatric syndrome in care homes, especially among residents living with dementia. Delirium is associated with substantial morbidity, mortality and preventable healthcare complications, yet evidence on how it is recognised and managed in re...

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Published in:Age & Ageing Vol. 55; no. 3; pp. 1 - 8
Main Authors: Russell, Olivia J, Ameen-Ali, Kamar E, Flynn, Angela C, Barnes, Sarah, Ferguson, Jennifer, Divers, Andrew, Newbury-Birch, Dorothy, Eberhardt, Judith, Young, John S, Krishnan, Mani Santhana
Format: Article
Published: Oxford University Press / USA Mar2026
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Mar2026
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      pub: Oxford University Press / USA
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        10.1093/ageing/afag056
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          Russell, Olivia J
          Ameen-Ali, Kamar E
          Flynn, Angela C
          Barnes, Sarah
          Ferguson, Jennifer
          Divers, Andrew
          Newbury-Birch, Dorothy
          Eberhardt, Judith
          Young, John S
          Krishnan, Mani Santhana
        affil:
          Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, NE2 4AX, England, UKSchool of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, England, UK
          School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, England, UK
          School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, D02 YN77, Ireland
          Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, S1 4DA, England, UK
          School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, TS1 3BX, England, UK
          Lustrum Vale, Tees Esk and Wear Valleys NHS Foundation Trust, Durham Road, Stockton-on-Tees, TS19 0EA, England, UK
      su:
        England
        United Kingdom
        Medical quality control
        Qualitative research
        Interprofessional relations
        Nursing care facilities
        Diagnosis of delirium
        Judgment sampling
        Thematic analysis
        Attitudes of medical personnel
        Delirium
        Data analysis software
        Residential care
        Dementia patients
      sug:
        subj:
          Medical quality control
          Qualitative research
          Interprofessional relations
          Nursing care facilities
          England
          United Kingdom
          Nursing Care Facilities (Skilled Nursing Facilities)
          Community care facilities for the elderly
          Other Residential Care Facilities
          Diagnosis of delirium
          Judgment sampling
          Thematic analysis
          Attitudes of medical personnel
          Delirium
          Data analysis software
          Residential care
          Dementia patients
      keyword:
        care homes
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        https://dx.doi.org/10.1093/ageing/afag056
        inLanguage:en
        internship and residency
        medical residencies
        older people
        publisher:Oxford University Press
        qualitative research
        qualitative study
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41848758/
        thematic analysis
        care homes
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        delirium
        https://dx.doi.org/10.1093/ageing/afag056
        inLanguage:en
        internship and residency
        medical residencies
        older people
        publisher:Oxford University Press
        qualitative research
        qualitative study
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41848758/
        thematic analysis
      ab: Delirium is a common but frequently under-recognised neuropsychiatric syndrome in care homes, especially among residents living with dementia. Delirium is associated with substantial morbidity, mortality and preventable healthcare complications, yet evidence on how it is recognised and managed in residential care remains limited. This qualitative study explored care home managers' perspectives on delirium care within privately owned care homes in a region of England, UK, and data analysed thematically to identify key challenges and opportunities for improvement. Three overarching themes were identified: (1) Recognising and Responding to Delirium described how detection often relied on staff familiarity with residents' usual behaviour, with limited use of formal assessment tools and frequent difficulty distinguishing delirium from dementia, particularly in hypoactive presentations. (2) Systemic Barriers to Quality Care highlighted the impact of chronic underfunding, fragmented communication at hospital discharge, unclear clinical responsibility and limited access to training and clinical support. (3) Collaborative Care and Support Networks captured the role of families and external professionals in delirium management, with variable communication, inconsistent validation of care home concerns and challenges coordinating care across services. In response to these challenges, we recommend co-produced delirium education for care staff, clearer clinical pathways and stronger interprofessional collaboration to ensure that delirium is recognised and treated as a potentially life-threatening medical emergency.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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