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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Delirium issues in palliative care settings.

Maeve Leonard1, Meera Agar, Colin Mason

  • 1Midwestern Regional Hospital, Limerick, Ireland. maeveleonard@gmail.com

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Summary
This summary is machine-generated.

Delirium is common in palliative care, causing distress and complicating symptom management. More research is crucial for better recognition, assessment, and evidence-based treatment guidelines.

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Area of Science:

  • Palliative Care Medicine
  • Geriatric Psychiatry
  • Oncology

Background:

  • Delirium is a frequent and distressing complication in palliative care settings.
  • It significantly impedes accurate symptom assessment, particularly pain.
  • The condition impacts patients, carers, and families, necessitating focused research.

Purpose of the Study:

  • To conduct an expert review of delirium within the palliative care context.
  • To highlight research gaps and inform future studies.

Main Methods:

  • Systematic literature review focusing on populations with advanced cancer or receiving palliative care.
  • Inclusion of studies with standard outcome measures and those identifying delirium research issues.
  • Analysis of existing literature to synthesize current knowledge and identify deficits.

Main Results:

  • A significant lack of rigorous studies on delirium in palliative care.
  • Inconsistent terminology and assessment tools contribute to variable incidence and prevalence data.
  • Delirium is often multifactorial, can indicate a poor prognosis, but may be reversible with interventions.
  • Pharmacological management, primarily with antipsychotics, lacks robust evidence for efficacy and safety.
  • Symptomatic control is often sufficient, with palliative sedation considered for refractory cases.

Conclusions:

  • Urgent need for research into delirium recognition and phenomenology in palliative care.
  • Development of low-burden assessment tools and family education strategies is required.
  • Further investigation into predictive models for reversibility and evidence-based guidelines for palliative sedation is essential.