Management of delirium in critically ill older adults

Michele C. Balas, Michael Rice, Claudia M Chaperon, Heather Smith, Maureen Disbot, Barry Fuchs

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.

Original languageEnglish (US)
Pages (from-to)15-26
Number of pages12
JournalCritical Care Nurse
Volume32
Issue number4
DOIs
StatePublished - Aug 1 2012

Fingerprint

Delirium
Critical Illness
Nurse-Patient Relations
Physical Restraint
Confusion
Institutionalization
Aptitude
Critical Care
Hypnotics and Sedatives
Psychological Stress
Artificial Respiration
Catheters
Nurses
Costs and Cost Analysis
Mortality

ASJC Scopus subject areas

  • Critical Care

Cite this

Balas, M. C., Rice, M., Chaperon, C. M., Smith, H., Disbot, M., & Fuchs, B. (2012). Management of delirium in critically ill older adults. Critical Care Nurse, 32(4), 15-26. https://doi.org/10.4037/ccn2012480

Management of delirium in critically ill older adults. / Balas, Michele C.; Rice, Michael; Chaperon, Claudia M; Smith, Heather; Disbot, Maureen; Fuchs, Barry.

In: Critical Care Nurse, Vol. 32, No. 4, 01.08.2012, p. 15-26.

Research output: Contribution to journalArticle

Balas, MC, Rice, M, Chaperon, CM, Smith, H, Disbot, M & Fuchs, B 2012, 'Management of delirium in critically ill older adults', Critical Care Nurse, vol. 32, no. 4, pp. 15-26. https://doi.org/10.4037/ccn2012480
Balas, Michele C. ; Rice, Michael ; Chaperon, Claudia M ; Smith, Heather ; Disbot, Maureen ; Fuchs, Barry. / Management of delirium in critically ill older adults. In: Critical Care Nurse. 2012 ; Vol. 32, No. 4. pp. 15-26.
@article{a8db5c863a284444907dc0019a4dbd1f,
title = "Management of delirium in critically ill older adults",
abstract = "Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.",
author = "Balas, {Michele C.} and Michael Rice and Chaperon, {Claudia M} and Heather Smith and Maureen Disbot and Barry Fuchs",
year = "2012",
month = "8",
day = "1",
doi = "10.4037/ccn2012480",
language = "English (US)",
volume = "32",
pages = "15--26",
journal = "Critical Care Nurse",
issn = "0279-5442",
publisher = "American Association of Critical Care Nurses",
number = "4",

}

TY - JOUR

T1 - Management of delirium in critically ill older adults

AU - Balas, Michele C.

AU - Rice, Michael

AU - Chaperon, Claudia M

AU - Smith, Heather

AU - Disbot, Maureen

AU - Fuchs, Barry

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.

AB - Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.

UR - http://www.scopus.com/inward/record.url?scp=84869420711&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869420711&partnerID=8YFLogxK

U2 - 10.4037/ccn2012480

DO - 10.4037/ccn2012480

M3 - Article

VL - 32

SP - 15

EP - 26

JO - Critical Care Nurse

JF - Critical Care Nurse

SN - 0279-5442

IS - 4

ER -