Distress in delirium: causes, assessment and management

Area of Science:

• Gerontology
• Psychiatry
• Clinical Medicine

Background:

• Delirium is a prevalent clinical syndrome linked to adverse outcomes like increased morbidity, mortality, and healthcare costs.
• There is a growing need to understand the psychological impact of delirium, including distress, on patients, families, and healthcare providers.

Purpose of the Study:

• To review distress in delirium (DID), focusing on its impact on older adults.
• To explore patient and environmental risk factors, variations in DID across clinical settings, and available assessment tools.
• To outline management strategies for preventing and limiting distress in delirium.

Main Methods:

• Narrative review of qualitative and quantitative research.
• Analysis of patient and environmental risk factors for DID.
• Overview of distress assessment tools and management strategies.

Main Results:

• Both severe illness and delirium induce distress; patients recall specific experiential features.
• Relatives witnessing delirium experience distress, potentially exceeding that of patients.
• Distress in delirium can lead to long-term psychological sequelae lasting months to years.

Conclusions:

• Understanding the experience and long-term psychological harm of delirium is crucial.
• Targeted support and information for at-risk patients and their families can reduce distress.
• Improved clinician awareness will facilitate better patient and family care.