Developing guidelines on the assessment and treatment of delirium in older adults at the end of life

Canadian Geriatrics Journal

Volumn 14, Issue 2, 2011, Pages 40-50

  Brajtman, Susan ^a   Wright, David ^a   Hogan, David B ^b   Allard, Pierre ^a   Bruto, Venera ^c   Burne, Deborah ^d,e   Gage, Laura ^f   Gagnon, Pierre R ^g   Sadowski, Cheryl A ^h   Helsdingen, Sherri ⁱ   Wilson, Kimberley ⁱ  

^a UNIVERSITY OF OTTAWA   (Canada)

^b UNIVERSITY OF CALGARY   (Canada)

^c UNIVERSITY OF GUELPH   (Canada)

^d SHERIDAN COLLEGE   (Canada)

^e ONTARIO SHORES CENTRE FOR MENTAL HEALTH SCIENCES   (Canada)

^f UNIVERSITY OF TORONTO   (Canada)

^g LAVAL UNIVERSITY   (Canada)

^h UNIVERSITY OF ALBERTA   (Canada)

ⁱ Canadian Coalition for Seniors' Mental Health   (Canada)

Author keywords

Delirium; End of life; Evidence based practice; Guidelines; Older adults; Palliative care

Indexed keywords

EID: 85015156162     PISSN: None     EISSN: 19258348     Source Type: Journal    
DOI: None     Document Type: Review

References (57)

1. Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med 2000; 160:786-94.
2. Gagnon PR. Treatment of delirium in supportive and palliative care. Curr Opin Support Palliat Care 2008; 2:60-6.
3. Roth AJ, Breitbart W. Psychiatric emergencies in terminally ill cancer patients. Hematol Oncol Clin North Am 1996; 10:235-59.
4. Maluso-Bolton T. Terminal agitation. J Hosp Palliat Nurs 2000; 2:9-20.
5. Brajtman S. The impact on the family of terminal restlessness and its management. Palliat Med 2003; 17: 454-60.
6. Morita T, Akechi T, Ikenaga M, et al. Terminal delirium: recommendations from bereaved families' experiences. J Pain Symptom Manage 2007; 34:579-89.
7. Namba M, Morita T, Imura C, et al. Terminal delirium: families' experience. Palliat Med 2007; 21:587-94.
8. Braiteh F, El Osta B, Palmer JL, et al. Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center. J Palliat Med 2007; 10: 948-55.
9. Ganzini L. Care of patients with delirium at the end of life. Ann Long Term Care 2007; 15(3):35-40.
10. Harris D. Delirium in advanced disease. Postgrad Med J 2007; 83:525-8.
11. Levy MH, Back A, Benedetti C, et al; National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: palliative care [Internet]. Fort Washington, PA: NCCN; 2011 [cited 2011 Feb 15]. Available from: http://www.nccn.org/professionals/physician-gls/pdf/palliative.pdf
12. Canadian Coalition for Seniors' Mental Health. The CCSMH national guidelines for seniors' mental health: the assessment and treatment of delirium [Internet]. Toronto: CCSMH; 2006 [cited 2011 Feb 17]. Available from: http://www.ccsmh.ca/en/natlGuidelines/initiative.cfm.
13. Clinical Epidemiology. and Health Service. Evaluation Unit, Melbourne Health; Delirium Clinical Guidelines Expert Working Group. Clinical practice guidelines for the management of delirium in older people [Internet]. Melbourne, Australia: Victorian Government Department of Human Services; 2006 [cited 2011 Feb 10]. Available from: http://www.health.vic.gov.au/acute-agedcare/delirium-cpg.pdf.
14. British Geriatrics Society. Guidelines for the prevention, diagnosis and management of delirium in older people in hospital [Internet]. London, UK: British Geriatrics Society; 2006 [cited 2011 Feb 10]. Available from: http://www.bgs.org.uk/Publications/Clinical%20Guidelines/clinical-1-2-fulldelirium.htm.
15. Allard P, Brajtman S, Brazil K, et al. Optimizing research on end-of-life care for seniors. Geriatr Today 2003; 6:173-6.
16. Shekelle PG, Woolf SH, Eccles M, et al. Clinical guidelines: developing guidelines. BMJ 1999; 318:593-6.
17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, 4th ed, text revision. Washington, DC: American Psychiatric Association, 2000.
18. Plonk WM, Arnold RM. Terminal care: the last weeks of life. J Palliat Med 2005; 8:1042-54.
19. Breitbart W, Gibson C, Tremblay A. The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics 2002; 43:183-94.
20. Bruera E, Bush SH, Willey J, et al. Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers. Cancer 2009; 115:2004-12.
21. Spiller JA, Keen JC. Hypoactive delirium: assessing the extent of the problem for inpatient specialist palliative care. Palliat Med 2006; 20:17-23.
22. Ouimet S, Riker R, Bergeron N, et al. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007; 33:1007-13.
23. Centeno C, Sanz A, Bruera E. Delirium in advanced cancer patients. Palliat Med 2004; 18:184-94.
24. Leonard M, Raju B, Conroy M, et al. Reversibility of delirium in terminally ill patients and predictors of mortality. Palliat Med 2008; 22: 848-54.
25. Gagnon P, Allard P, Masse B, et al. Delirium in terminal cancer: a prospective study using daily screening, early diagnosis, and continuous monitoring. J Pain Symptom Manage 2000; 19:412-26.
26. Macleod AD. Delirium: the clinical concept. Palliat Support Care 2006; 4:305-12.
27. Macleod AD. The management of terminal delirium. Indian J Palliat Care 2006; 12:22-28.
28. Canadian Hospice Palliative Care Association. A model to guide hospice palliative care: based on national principles and norms of practice [Internet]. Ottawa: CHPCA; 2002 [cited 2011 Feb 17]. Available from: http://www.chpca.net/model-to-guide-hpc.
29. Corr CA. Hospice: achievements, legacies, and challenges. Omega (Westport) 2007-2008; 56:111-20.
30. Davies E, Higginson IJ, eds. Better palliative care for older people [Internet]. Geneva: World Health Organization; 2004 [cited 2011 Feb 17]. Available from: http://www.euro.who.int/-data/assets/pdf-file/0009/98235/E82933.pdf.
31. Pastrana T, Jünger S, Ostgathe C, et al. A matter of definition: key elements identified in a discourse analysis of definitions of palliative care. Palliat Med 2008; 22:222-32.
32. Twycross R. Patient care: past, present, and future. Omega (Westport) 2007-2008; 56: 7-19.
33. Meagher DJ. Delirium: optimizing management. BMJ 2001; 322:144-9.
34. White S, Bayer A. Delirium: a clinical overview. Rev Clin Gerontol 2007; 17:45-62.
35. Casarett DJ, Inouye SK. Diagnosis and management of delirium near the end of life. Ann Intern Med 2001; 135:32-40.
36. Lyness JM. End-of-life care: issues relevant to the geriatric psychiatrist. Am J Geriatr Psychiatry 2004; 12:457-72.
37. Kaldjian LC, Curtis AE, Shinkunas LA, et al. Goals of care toward the end of life: a structured literature review. Am J Hosp Palliat Care 2008; 25:501-11.
38. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189-98.
39. Tombaugh TN, McIntyre NJ. The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc 1992; 40:922-35.
40. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the Confusion Assessment Method: a new method for detection of delirium. Ann Intern Med 1990; 113:941-8.
41. Wei LA, Fearing MA, Sternberg EJ, et al. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc 2008; 56:823-30.
42. Ryan K, Leonard M, Guerin S, et al. Validation of the Confusion Assessment Method in the palliative care setting. Palliat Med 2009; 23:40-5.
43. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the intensive care unit (CAM-ICU). JAMA 2001; 286:2703-10.
44. Ely EW, Margolin R, Francis J, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med 2001; 29:1370-9.
45. Trzepacz PT, Mittal D, Torres R, et al. Validation of the Delirium Rating Scale-Revised-98: comparison with the Delirium Rating Scale and the Cognitive Test for Delirium. J Neuropsychiatry Clin Neurosci 2001; 13:229-42.
46. Albert MS, Levkoff SE, Reilly C, et al. The Delirium Symptom Interview: an interview for the detection of delirium symptoms in hospitalized patients. J Geriatr Psychiatry Neurol 1992; 5:14-21.
47. Breitbart, W, Rosenfeld B, Roth A, et al. The Memorial Delirium Assessment Scale. J Pain Symptom Manage 1997; 13:128-37.
48. Lawlor PG, Nekolaichuk C, Gagnon B, et al. Clinical utility, factor analysis, and further validation of the Memorial Delirium Assessment Scale in patients with advanced cancer: assessing delirium in advanced cancer. Cancer 2000; 88:2859-67.
49. Fadul N, Kaur G, Zhang T, et al. Evaluation of the Memorial Delirium Assessment Scale (MDAS) for the screening of delirium by means of simulated cases by palliative care health professionals. Support Care Cancer 2007; 15:1271-6.
50. Gaudreau JD, Gagnon P, Harel F, et al. Fast, systematic, and continuous delirium assessment in hospitalized patients: the Nursing Delirium Screening Scale. J Pain Symptom Manage 2005; 29:368-75.
51. de Graeff A, Dean M. Palliative sedation therapy in the last weeks of life: a literature review and recommendations for standards. J Palliat Med 2007; 10:67-85.
52. Quill TE, Byock IR. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. Ann Intern Med 2000; 132:408-14.
53. Cowan JD, Walsh D. Terminal sedation in palliative medicine: definition and review of the literature. Support Care Cancer 2001; 9:403-7.
54. Caraceni A, Simonetti F. Palliating delirium in patients with cancer. Lancet Oncol 2009; 10:164-72.
55. Kress JP, Hall JB. Delirium and sedation. Crit Care Clin 2004; 20:419-33, ix.
56. Leonard M, Agar M, Mason C, et al. Delirium issues in palliative care settings. J Psychosom Res 2008; 65:289-98.
57. Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet 2003; 362:1225-30.