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Dysgraphia and terminal delirium

A D Macleod1, L E Whitehead

  • 1Burwood Hospice, Christchurch, New Zealand.

Palliative Medicine
|March 1, 1997
PubMed
Summary

Delirium, often missed in palliative care, impairs consciousness. A simple writing test effectively identifies this condition in hospice patients, aiding accurate bedside diagnosis.

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Area of Science:

  • Palliative Medicine
  • Neurology
  • Geriatrics

Background:

  • Delirium is common in palliative care but frequently unrecognized or misdiagnosed.
  • Impaired consciousness is a key feature of delirium.
  • Writing ability is a sensitive, yet underutilized, indicator of consciousness impairment.

Purpose of the Study:

  • To investigate the utility of writing assessment as a bedside diagnostic tool for delirium in hospice patients.
  • To determine if specific writing impairments correlate with delirium.

Main Methods:

  • Ten delirious hospice patients were assessed using the Frenchay Aphasia Screening Test.
  • A simple clinical task involving writing 'name and address' was administered.
  • Writing function was evaluated for dysgraphic errors.

Main Results:

  • Writing was the most impaired language function identified by the Frenchay Aphasia Screening Test in delirious patients.
  • Overt dysgraphic errors were observed in the 'name and address' writing task among these patients.
  • The writing assessment proved to be a clinically acceptable bedside test.

Conclusions:

  • Simple writing tasks can reveal significant dysgraphic errors in delirious patients.
  • Bedside writing assessment is a potentially accurate and feasible method for diagnosing delirium in hospice settings.
  • This method offers a valuable tool for improving delirium recognition in palliative care.

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