Management of delirium in critically ill older adults

Michele C. Balas, Michael Rice, Claudia Chaperon, Heather Smith, Maureen Disbot, Barry Fuchs

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.

Original languageEnglish (US)
Pages (from-to)15-26
Number of pages12
JournalCritical Care Nurse
Volume32
Issue number4
DOIs
StatePublished - Aug 2012

ASJC Scopus subject areas

  • Critical Care

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