The PINCHME acronym for identifying and managing potential causes of delirium
| Pain | Treat pain appropriately, and identify and manage the underlying cause of the pain. |
| Infection | Identify and treat infection only if it is present. |
| Nutrition | Encourage oral nutritional intake with foods that the patient enjoys, ideally high in calories. Weigh the patient and refer to a dietitian as appropriate. |
| Constipation | Constipation should be treated and preventative measures should be considered if prescribing opiates. |
| Hydration | Encourage hydration through oral routes, with a focus on ‘little and often’ if there is not a huge desire to drink. In some cases, intravenous hydration will be required. |
| Medications | Review medication and stop or reduce those that may be contributing to the delirium if it is safe to do so. There may be an opportunity to suspend non-essential medications, which can be helpful in promoting other oral intake if this is a priority. Consider use of STOPP/START criteria. |
| Environment | Use reorientation devices (such as clocks and calendars) and lighting that is appropriate to the time of day to promote natural sleep. Photographs of relatives and family visiting can promote a feeling of normality. |
START = Screening Tool to Alert to Right Treatment; STOPP = Screening Tool of Older Persons' Prescriptions.