Skip to main content Accessibility help
×
Home
Hostname: page-component-8bbf57454-wdwc2 Total loading time: 0.829 Render date: 2022-01-26T09:05:55.846Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Book contents

15 - Recognition and Management of Delirium

Published online by Cambridge University Press:  19 May 2010

Christine Arenson
Affiliation:
Jefferson Medical College, Philadelphia
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Kenneth Brummel-Smith
Affiliation:
Florida State University
James G. O'Brien
Affiliation:
University of Louisville, Kentucky
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University, Washington DC
Get access

Summary

DELIRIUM

Delirium may be the most common and serious psychiatric problem affecting hospitalized older adults. Delirium is an acute fluctuating process of brain failure affecting, especially, attention and cognition. It is associated with many negative sequelae including increased mortality, cost, duration of stay, and risk of nursing home placement, or extended care at home. Despite this fact, delirium is frequently not recognized and if recognized not properly treated.

Delirium can be conceptualized as brain failure similar to heart failure or renal failure in which the cause or precipitating event may be intrinsic to the organ or, more commonly, extrinsic to the organ. Thus infection, electrolyte imbalances, metabolic disturbances, or medications may result in delirium. Delirium is to the older adult what fever is to the infant – a non-specific manifestation of an underlying problem. In the older adult, the brain may be similar to a circuit breaker, thus the weakest link, in an electrical system, which, when subjected to overload, will be the first to fail. Delirium in the older adult is probably a more common manifestation of illness than fever or pain.

EPIDEMIOLOGY

Delirium is a frequent event in hospitalized elderly patients with 14%–24% being affected at time of admission (prevalence) with an additional 6%–56% developing delirium during the course of hospitalization (incidence). Data from the United Kingdom suggest similar prevalence and incidence with reports of 7%–61% of older patients developing delirium during hospitalization. Delirium adds greatly to the cost of care both in the hospital and postdischarge.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 171 - 175
Publisher: Cambridge University Press
Print publication year: 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats
×

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats
×