Alasdair MacLullich
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amaclullich.bsky.social
Alasdair MacLullich
@amaclullich.bsky.social
Physician & Professor of Geriatric Medicine @EdinburghUni.

Chair, Scottish Hip Fracture Audit.

Delirium, hip fracture.

Free chapter of new book: https://www.the4at.com/family-delirium-guide
Pinned
There's a real gap in public information on #delirium & I'm aiming to help address this with this book.

Get a pdf of Chapter 1 via this link:

www.the4at.com/family-delir...

#familycaregiver
Delirium has a visibility problem, not just a diagnostic one.

How many cases of delirium are you missing day to day by not looking proactively?
November 11, 2025 at 7:58 AM
"Care partners of people with dementia often feel isolated. A dementia-friendly community provides a network of support for care partners, connecting them with resources and other people who understand their experience."

— Dementia Friendly America
November 8, 2025 at 9:17 PM
"I was in a fever, and everything seemed to be spinning around me."

Gitanjali (Poem), Rabindranath Tagore

#delirium
November 8, 2025 at 12:04 PM
“Nobody used the word delirium. I thought I’d lost my mind.”

— Delirium survivor

➡️ Always provide clear information, including telling the patient they have delirium, during the episode. Then explain & de-brief afterwards.
November 7, 2025 at 7:53 AM
Emergency Department (ED) staff: screen ALL patients over 65 for delirium.

Emergency departments are where it's most missed and most dangerous.

Make it as routine as checking blood pressure.
November 6, 2025 at 7:49 AM
😞 Social isolation and loneliness in older people.

🇨🇦 From the Canadian Coalition for Seniors' Mental Health.

#DementiaCare #MedTwitter
November 5, 2025 at 8:06 AM
Delirium develops over hours/days, dementia over months/years.

"Dad was fine yesterday, today he's a different person" = think delirium, not dementia progression.
November 4, 2025 at 7:58 AM
"Providing person-centered care is essential for improving the quality of life for people with dementia. This involves tailoring care to the individual's unique needs, preferences, and values."

— National Council of Certified Dementia Practitioners (NCCDP)
November 1, 2025 at 9:20 PM
"He saw visions of his ancestors, they were calling him, he could not understand."

Love in the Time of Cholera, Gabriel García Márquez

#delirium
November 1, 2025 at 12:04 PM
“I needed to be told the date every time. Repetition ≠ patronising.”

#delirium
October 31, 2025 at 7:53 AM
Does your patient need you to provide reassurance?

Kindness goes a long way in #delirium.
October 30, 2025 at 7:49 AM
Factsheet - Frailty and deterioration

#frailty
October 29, 2025 at 8:06 AM
Explain delirium in accessible terms: "The brain isn't processing information normally right now."

This helps families understand why repeating basics about what is going on, as well as being reassuring over and over again, can help the person experiencing #delirium.
October 28, 2025 at 7:58 AM
"Family caregivers are essential partners in the care of people with dementia, and their needs must be recognized and addressed by the healthcare system."

— The College of Family Physicians of Canada (CFPC)
October 25, 2025 at 8:17 PM

"In the deepest slumber—no! In #delirium—no! In a swoon—no! In death—no! even in the grave all is not lost. Else there is no immortality for man."

The Pit and the Pendulum by Edgar Allan Poe
October 25, 2025 at 11:04 AM
“My brain was the enemy; it told me the nurses were killers.”

— Delirium survivor

Psychological care of delirium starts with reality anchoring: “You’re safe, you’re in hospital, I’m your nurse.”
October 24, 2025 at 6:53 AM
Emergency Department (ED) staff: screen ALL patients over 65 for delirium.

Emergency departments are where it's most missed and most dangerous.

Make it as routine as checking blood pressure.
October 23, 2025 at 6:49 AM
Falls prevention in over 65s.

#falls
October 22, 2025 at 7:06 AM
All these informal terms - avoiding saying "delirium" - makes care FAR less effective.

Use #DELIRIUM.
October 21, 2025 at 6:58 AM
"Up to 40% of antipsychotic use in long-term care may be inappropriate, leading to an increased risk of falls, fractures, and death."

— Healthcare Excellence Canada
October 18, 2025 at 8:17 PM

"But if you notice anything - #delirium or fever - wake me at once."

"Crime and Punishment by Dostoevsky
October 18, 2025 at 11:04 AM
A feeling of loneliness or isolation is commonly reported in people experiencing #delirium.

Don't leave them feeling like this. Speak kindly, explain what is happening, involve family.
October 17, 2025 at 6:53 AM
"Have you been having a difficult time?"

"Is there anything I can do to help you?"

➡️ Questions to help provide comfort to those with #delirium & #dementia
October 16, 2025 at 6:49 AM
Useful facts on Alzheimer's Disease. Note especially the huge contribution that carers make.
October 15, 2025 at 7:06 AM
"I can't remember" – Patients who have had #delirium often experience a feeling of 'lost time'. You can help by clearly explaining what delirium is & answering their questions. Give them a narrative of what has happened to them.
October 14, 2025 at 6:58 AM