Improving prevention, treatment and recovery of delirium

Delirium is a sudden change in thinking, attention and awareness that commonly occurs during illness or after surgery. It can be thought of as "acute brain failure", where the brain temporarily stops working normally.

Dr Anita Nitchingham is a Geriatrician at Prince of Wales Hospital and a Conjoint Lecturer at UNSW, specialising in delirium in older people. Dr Nitchingham’s research focuses on improving the prevention, treatment and recovery of delirium to help older adults maintain their independence and brain health.

Dr Nitchingham is particularly interested in recovery after delirium as it is a major risk factor for dementia, with up to 30% of older people discharged from hospital with ongoing delirium symptoms. As a clinician, she sees this as a missed opportunity to better support recovery and improve long-term outcomes.

Through a SPHERE Health Innovation Fellowship project, The Missing Link: Implementing a tiered post-discharge pathway to enhance resilience and recovery after delirium, Dr Nitchingham aims to transform how we care for people after they leave hospital.

This project will co-design, implement and evaluate a tiered post-discharge delirium recovery pathway that provides the right level of support based on each person's needs. The pathway will focus on early assessment, education for patients and carers, optimisation of brain health, rehabilitation, and timely referral to specialist services where required. By embedding this model into routine clinical practice, the researchers hope to improve recovery while making better use of existing health services.

The Fellowship provides dedicated time and resources to work with clinicians, researchers and people with lived experience to co-design, implement and evaluate the recovery pathway. The fellowship also provides access to expertise in implementation science, digital health and consumer partnership, together with a multidisciplinary network spanning health services, universities and research institutes. This collaborative approach will help ensure the pathway is practical, sustainable and embedded into routine care, with the potential to improve outcomes for patients well beyond the completion of the project.

The project brings together experts from across the District, UNSW, UTS, NeuRA and The George Institute. Professor Jacqui Close provides expertise in health service development and mentorship, Dr Amy Montgomery leads consumer co-design, Professor Meera Agar provides expertise in implementation science, Scientia Professor Nigel Lovell contributes expertise in digital health, Professor Gideon Caplan provides expertise in delirium care, Dr Kate Mullin contributes expertise in psychological recovery, and Dr Jacob Dye brings both lived experience of delirium and expertise in recovery research.

Together, this multidisciplinary team combines expertise in delirium, implementation science, digital health, consumer co-design and recovery. By working across disciplines and partnering with people with lived experience from the outset, the team aim to develop a practical, effective and sustainable model of care that can be embedded into routine practice.

Recovery after delirium represents a critical window to support brain health, yet it is currently overlooked. By intervening at this pivotal time, the researchers hope to improve recovery and reduce the risk of ongoing cognitive and functional decline.

Through structured follow-up and personalised care after discharge, the team aims to improve cognitive and physical recovery, provide psychological support for patients and families, reduce hospital readmissions, and help people maintain their independence and quality of life. If successful, this project could provide a scalable model for post-delirium care across NSW and beyond, with the potential to improve both short- and long-term outcomes for older Australians.

11 August 2026