Delirium Care Pathways

Poole's Algorithm: Nursing Management of Disturbed Behaviour in Older People

Page last updated: 07 November 2011


    Poole's Algorthm Flowchart - text description below.


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    Poole's Algorithm

    Is the person displaying aggressive, confused or inappropriate behavior?
    If the person is aggressive, aim for safety, look for a stressor and remedy.
    Could there be medical problems? If the person is not aggressive, instigate supportive communication and care techniques.

    If the person is not aggressive, or the person is aggressive but there could be other medical problems, could the person have delirium?
    If yes, assess and treat the cause.
    Could there be other medical problems?
    If no, instigate supportive communication and care techniques.

    If the person does not have delirium, or the person has delirium but there are other medical problems, could the person have depression or a mental disorder?
    If yes, assess and treat the problem.
    Could there be other medical problems?
    If no, instigate supportive communication and care techniques.

    If the person does not have depression or a mental disorder, or the person does have depression or a mental disorder but there could be other medical problems, could the person have dementia?
    If yes, assess and plan for the management of the condition including ongoing care.
    Instigate supportive communication and care techniques.



    Adapted from: Poole, J 2002, Poole's Algorithm: Nursing management of disturbed behaviour in older people in acute care, Sydney; Department of Aged Care and Rehabilitation Medicine, Royal North Shore Hospital & Community Health Services