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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Delirium Prevention and Management in Older Adults in the Emergency Department
Rachel M Skains1, Sangil Lee2, Jin H Han3
1Department of Emergency Medicine, University of Alabama at Birmingham School of Medicine, 521 19th Street South, Suite 203, Birmingham, AL 35233, USA; Geriatric Research, Education, and Clinical Center, Birmingham Veterans Affairs Medical Center, 700 19th Street South, Birmingham, AL 35233, USA.
Abstract:
Delirium, acute brain dysfunction, is present in 10% to 35% of older adults in the emergency department (ED) but unrecognized in ∼80% of cases leading to significant adverse outcomes. Thus, routine screening for delirium is vital to improve prevention and management in the ED. The treatment of delirium focuses on addressing the underlying cause. For agitation, nonpharmacologic measures using the Tolerate, Anticipate, and Don't Agitate (TADA) approach and the Assess, Diagnose, Evaluate, Prevent, and Treat (ADEPT) tool are prioritized for management. If unsuccessful, only the lowest effective dose of pharmacologic agents (atypical antipsychotics) should be used for severe symptom control.
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