Delirium in the long-term care setting: clinical and research challenges

Delirium is a common problem in post-acute and long-term care. We present an updated review of delirium in those settings. Special considerations are the border between delirium and dementia, and in knowing when what presents as delirium might be the type of preterminal cognitive decline that manifests among people who are dying. A work-up that focuses on the common causes of delirium (which, in essence, are the common illnesses that befall frail older adults) is likely to have a high yield. We note that preventing delirium requires a multicomponent approach, the details of much of which is known, but nevertheless have proved to be challenging to bring about in routine care.