Investigation of the Delirium Observation Screening Scale (DOSS) for the outline detection of delirium in the Care Home Setting: The DOSS Study 

Delirium (an acute confusional state) is a common and serious condition that is associated with increased risk of hospital admission, falls, lasting memory problems and death. Individuals suffering from an episode of delirium often have altered perception of their surroundings and frequently misinterpret their environment. This may result in behaviours out of keeping with personality which can be deeply distressing and frightening for the person, their family and their carers. There are many factors which may precipitate delirium, often associated with the quality of basic care – for example dehydration, pain, constipation and culprit medications. These risk factors for delirium are prevalent in care homes where residents may be frail, with multiple co-morbidities, often including dementia. Attention to the factors known to cause the development of delirium may help to prevent progression and consequent poor outcomes. The aim of this study is to investigate whether a simple screening tool for delirium, that has been shown to be reliable in the detection of delirium in the hospital setting, might have utility in the detection of delirium as part of routine care in care-homes, and whether it can be used to assess delirium severity. A reliable method of routine delirium detection in care homes could have substantial benefits for care home residents, staff and the wider NHS, and form the basis for future research in long-term care settings