Intended for healthcare professionals


The German hospital tackling delirium in patients with dementia

BMJ 2020; 371 doi: (Published 23 November 2020) Cite this as: BMJ 2020;371:m4361
  1. Priti Salian
  1. Berlin, Germany
  1. pritisalian{at}

Delirium affects a large proportion of hospital patients, particularly those with dementia. One Berlin hospital is tackling the root causes, writes Priti Salian

On a cold winter morning, just before daybreak, Neele Schubert walks swiftly from her room to the geriatric ward for acutely ill dementia patients at the Protestant Hospital Queen Elisabeth Herzberge (KEH) in Berlin, Germany.

She waits as long as it takes for her patient to wake up and then helps her to stand. They walk together in the room for a while before moving on to washing and dressing. All the while Schubert orients her patient, “It’s a cold January morning in 2020, and today is a Monday. Do you know that we are in Berlin, your hometown?”

Schubert, 20, is one of the 12 trained federal volunteers invited by KEH to be the single point of contact for dementia patients during hospitalisation. It is one of the strategies the public multispecialty hospital has adopted to prevent delirium, specifically in those living with dementia, who find themselves lost in an unfamiliar environment and are easily irritated by constant interactions with strangers, who they perceive as a threat.

Delirium is a rapid change in brain functioning leading to confused thinking and reduced awareness of the environment, often caused by severe illness and hospitalisation. It puts patients at a higher risk of falls, reducing their mental acuity and survival rate.1 Stretching hospital stay, it escalates healthcare costs by 2.5 times.2

Researchers have estimated that around 65% of those who develop delirium in hospital settings also have dementia. …

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