Delirium is under-recognised but is surprisingly a common problem, particularly among older people who are hospitalised. People who have delirium have trouble thinking clearly, focusing their thoughts, and paying attention. It can be frightening, however there are many ways it can be prevented or properly managed. Usually a direct cause can be identified, such as medication, an infection, dehydration, and kidney failure.
If left untreated, delirium can have serious consequences for a patient's recovery.
What are we trying to achieve?
Although we have previously undertaken an organisational project to improve the management of patients with delirium under our care [view our delirium story from our Quality Account 2012/13], we are always looking for new ways to better manage our patients’ symptoms and reduce their distress.
One non-pharmacological approach to manage symptoms is the use of ‘comfort’ or ‘fiddle mitts’ which have been found to provide visual, tactile and sensory stimulation for patients who fidget or need comforting. They also provide a distraction to patients who may otherwise pull at lines (eg IV or catheter), tubes or dressings.
What have we done?
A group of knitters in West Auckland called the Sunday Girls and a Takapuna based craft group called Busy Fingers have been donating fiddle mitts to our gerontology units. These have been provided to patients on the wards who are experiencing delirium, pulling at lines or catheters, or who are distressed or agitated. This is a way of providing stimulation and to reduce some of their distress. These colorful knitted mitts have the added benefit of keeping our patients’ hands warm.
[View the story about our fiddle mitts initiative featured on Stuff]
Our gerontology nurse specialists and members of the Busy Fingers craft group showcasing their fiddle mitts
What can you do to help us?
- We would welcome any keen knitters who want to give knitting fiddle mitts a go, we have patterns available
- We also welcome donations of knitting needles, wool and any other associate items that you might have sitting around home
- Donations can be left with our clerk on Ward 14 at North Shore Hospital, alternatively please give Elaine Docherty a call on extension 486 8920 extn 7172
Did we make a difference?
The feedback from staff who have provided fiddle mitts for patients has been very positive:
"The fiddle mitts are great – they really work. When I have to do some work with my patient I use it – it helps provide a distraction and she doesn’t get distressed." - Registered Nurse
"I understand a patient with severe dementia was provided with a Fiddle Mitt because it was noted that she tended to reach out and touch her surroundings and became a little agitated when she was restricted from doing this. Once she was issued with a Fiddle Mitt, she would spend time fiddling and playing with the mitt enabling some of her agitation to decrease. This was also beneficial for her husband who reported saying that it was a great distraction for her." - Occupational Therapist
"The introduction of fiddle mitts has been of value to patients and staff. Most often I strive to find distraction techniques to help prevent patients pulling at unfamiliar equipment. These mitts help provide that distraction as they are very visual and draw the patient's attention to them instead." - Registered Nurse
Where to from here?
As part of the fiddle mitts project we are working at setting up a small knitting group on the older adults wards with support from Women’s Auxiliary volunteers and a church knitting group
This knitting group will have multiple benefits for patients and staff including:
- therapy for both managing and preventing delirium
- occupational therapy assessments - physical and cognitive
- reducing boredom
- stress and anxiety reduction - distraction
- engagement in purposeful activity
- producing fiddle mitts for our project