Delirium onset within a palliative care programme: nursing care for the patient and family

Abstract

Delirium is a neurocognitive syndrome correlated with increased risk of hospitalization, functional and cognitive impairment, and mortality. Patients under palliative treatment regime are at higher risk of developing the syndrome due to their debilitated physical condition. In this context delirium is one of the most frequent complications, affecting around 85% of people at the end of the life. It augments the distress of the expiring individual and their family, aggravating suffering and compromising the quality of the life of the terminally ill people. The aim is to prevent the incidence of delirium identifying people at risk. If an episode of delirium occurs, it is essential to identify it with specific clinical assessment tools, to assess and to treat reversible causes in combination with enviromental, psychological and pharmacological intervention to control the symptoms. The close supporting role of the nurse within the family group confers them a fundamental role in the recognition and management of delirium. It is essential to analyse the peculiarities of assistance for patients under palliative treatment affected by delirium, together with their family. To provide personalized treatment that offers support, relief and hope, considering the person as a whole within the family setting, nurses can use the taxonomy of Nanda international classification of nursing diagnosis (Nanda-I), Nursing outcomes classification (Noc) and Nursing interventions classification (Nic).