The prevalence of delirium upon resident admission to skilled nursing facilities (SNFs) fell after the Improving Medicare Post-Acute Care Transformation (IMPACT) Act was passed in 2014. Still, prevalence remains high and there is still more work to do to reduce cases of delirium, according to authors of a [study](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831647) published Monday in _JAMA Network Open._
The team found that delirium resolution during the stay improved in the five years since passage of the IMPACT Act. It assessed figures from 2014 and 2019, comparing data from both years.
The team examined records on 306,998 Medicare beneficiaries admitted to an SNF in Massachusetts. During that time, delirium prevalence at admission decreased from 4.3% in 2014 to 2.5% in 2019. Among people with delirium upon admission, persistent delirium declined from 62.3% to 54.7%, whereas delirium resolution went up during the study span from 29.1% to 37.4%.
The decline in delirium prevalence may be a result of other efforts at hospitals. Interventions such as the Hospital Elder Life Program, which has created protocols and guidelines to improve care, may have played a role in the improvements, the authors pointed out.
“Although improvements in delirium prevalence and resolution were observed … the high rate of persistent [delirium](https://www.mcknights.com/news/report-older-adults-with-delirium-dementia-have-worse-recovery-after-hospital-discharge-to-snfs/) underscores the need for improved delirium management in SNF,” the authors wrote.
Delirium is an acute disorder that causes fluctuating inattention, confusion and different levels of consciousness. It is linked to poor health outcomes and is considered an indicator of quality care. In many cases, it can be prevented.
Some research shows that 1 in every 5 patients had delirium when they left a hospital and went to a nursing home. Of them, 64% had worsening symptoms a week later, and 14% fully recovered, the authors noted.