Educating Family Caregivers for Older Adults About Delirium: A Systematic Review

Bull, Margaret J.; Boaz, Lesley; Jerme, Martha

doi:10.1111/wvn.12154

Cited by 27 publications

(18 citation statements)

References 24 publications

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“…For this reason, burden should be assessed in all caregivers of and patients with delirium. As with ADRD, caregiver and peer support programs, case management, counseling, education, and long‐term multicomponent programs should be explored as potential approaches to decrease caregiver distress in delirium. The caregiver interventions for delirium will need to be tailored to specific caregiver burden dimensions, and will likely vary widely among caregivers of patients with or without ADRD.…”

Section: Discussionmentioning

confidence: 99%

The Caregiver Burden of Delirium in Older Adults With Alzheimer Disease and Related Disorders

Fong

Racine

Fick

et al. 2019

J American Geriatrics Society

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Objectives: To measure the burden of delirium in older adults with or without Alzheimer disease or related disorders (ADRD) Design: Prospective, observational cohort Setting: Inpatient hospital, study participants’ homes Participants: A subset (n=267) of older medical and surgical patients and their caregivers enrolled in the Better Assessment of Illness (BASIL) study Measurements: Delirium burden was measured using the DEL-B instrument (range 0-40, higher scores indicate greater burden) in caregivers (DEL-B-C) and patients (DEL-B-P) one-month after hospitalization. Severity of cognitive impairment (Montreal Cognitive Assessment, MoCA), delirium presence (Confusion Assessment Method, CAM) and delirium severity (CAM-Severity, CAM-S) were measured during hospitalization and at one-month followup. ADRD diagnosis was determined by a clinical consensus process. Results: For patients with (n=56) and without (n=211) ADRD, both DEL-B instruments had good internal consistency. DEL-B-C scores had a median (interquartile range, IQR) among caregivers of patients with and without ADRD of 9 (5-15) and 5 (1-11), respectively (p<0.05). If the patient developed delirium, caregivers experienced greater burden (β[delirium×ADRD]=−0.29, p=.42), regardless of ADRD status. Further, caregiver burden was modestly correlated with patient MoCA scores (Spearman correlation coefficient, rho=−.18, p=.01). Patients with ADRD who developed delirium self-reported less burden than those without ADRD (β[delirium×ADRD]=−0.67, p=.044). As with caregivers, delirium burden was modestly correlated with patient MoCA score (rho=−.18, p=.005) and correlated with the CAM-S in patients without ADRD (rho=.38, p<.001) but not for patients with ADRD (rho=−.07, p=.61). Conclusions: Delirium resulted in the same degree of increased caregiver burden regardless of whether or not a patient had ADRD, signifying delirium is equally stressful to caregivers, even among those with experience caring for someone with a chronic cognitive disorder. Delirium burden is only modestly associated with degree of cognitive impairment, suggesting that other aspects of delirium contribute to burden.

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Section: Discussionmentioning

confidence: 99%

The Caregiver Burden of Delirium in Older Adults With Alzheimer Disease and Related Disorders

Fong

Racine

Fick

et al. 2019

J American Geriatrics Society

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“…However, support services after the recovery of delirium would also prove beneficial as there are evidences of recurrence. Providing brochures that discuss the aspects addressed above and non‐pharmacological interventions (for instance, reorienting and reassuring the older adult, bringing familiar objects from home) that might help in reducing the incidence and prevalence of delirium and in caring for the older adult with delirium would be helpful for family caregivers to refer to whenever in need (Bull, Boaz, & Jerme, 2016; Fong et al., 2009).…”

Section: Discussionmentioning

confidence: 99%

Family caregiver's experience of caring for an older adult with delirium: A systematic review

Shrestha

Fick

2020

Int J Older People Nursing

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Aim: To enhance understanding of how family caregivers perceive the experience of caring for an older adult with delirium across care settings and to identify the challenges in recognising and managing delirium to inform future research and best practices. Method: A systematic literature review was conducted in five databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Primary or secondary peer-reviewed articles published between 1987 and October 2018 describing the experiences of family caregivers caring for older adults with delirium or delirium superimposed on dementia were included in the review. Mixed Method Appraisal Tool (MMAT) was used to evaluate the methodological quality. A thematic synthesis of results was conducted to extract relevant data as per the aims of the study. Results: Eighteen articles met the eligibility criteria, which were reviewed and analysed in regard to purpose, sample, research design, variables and results. Seven themes emerged in the process. The current challenges and gaps in our knowledge of this phenomenon have also been highlighted, which should be helpful to inform best practices, and finally, an agenda for future research is proposed. How to cite this article: Shrestha P, Fick DM. Family caregiver's experience of caring for an older adult with delirium: A systematic review. Int J Older People Nurs.

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“…These interventions also improved older adults performance on instrumental activities of daily living, family caregivers knowledge of delirium and family caregivers preparedness to support older adults. Other studies have shown that family caregivers experienced less anxiety and presented fewer signs of depression throughout the care episode (Boltz et al, ; Bull, Boaz, & Jermé, ; Calvo et al, ; Lundstrom et al, ). In a study assessing the feasibility of nurses and family caregivers partnering to prevent delirium in hospitalized older adults, it was found that nurse and family caregiver knowledge of delirium increased significantly post‐intervention and that participants demonstrated significantly more respect, collaboration, and mutual support (Rosenbloom & Fick, ).…”

Section: Introductionmentioning

confidence: 94%

“…care episode (Boltz et al, 2014;Bull, Boaz, & Jermé, 2016;Calvo et al, 2012;Lundstrom et al, 2005). In a study assessing the feasibility of nurses and family caregivers partnering to prevent delirium in hospitalized older adults, it was found that nurse and family caregiver knowledge of delirium increased significantly post-intervention and that participants demonstrated significantly more respect, collaboration, and mutual support (Rosenbloom & Fick, 2014).…”

Section: Introductionmentioning

confidence: 99%

Understanding the integration of family caregivers in delirium prevention care for hospitalized older adults: A case study protocol

Cohen

Pereira

Kampel

et al. 2019

Journal of Advanced Nursing

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Aim To understand family caregiver involvement in delirium prevention care for older adults hospitalized for orthopaedic surgery hospitals and family caregiver integration by nurses. Design Multiple‐case study. Methods The model of Care Partner Engagement was selected as theoretical framework. Eight cases will comprise an older adult hospitalized a family caregiver and a ward nurse. They will be recruited with a non‐probability sampling on two orthopaedic surgery wards in two hospitals. Semi‐structured interviews with participants will be audiotaped. Sociodemographic data will be collected. These data, researcher field notes and interview transcripts will be subjected to within‐ and across‐case thematic analysis. Regional ethics committee approved the study protocol in August 2018. Discussion The study will allow surgical nursing teams to gain a better understanding of the issues and possibilities regarding family caregiver integration in delirium prevention care for older adults.

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Educating Family Caregivers for Older Adults About Delirium: A Systematic Review

Cited by 27 publications

References 24 publications

The Caregiver Burden of Delirium in Older Adults With Alzheimer Disease and Related Disorders

The Caregiver Burden of Delirium in Older Adults With Alzheimer Disease and Related Disorders

Family caregiver's experience of caring for an older adult with delirium: A systematic review

Understanding the integration of family caregivers in delirium prevention care for hospitalized older adults: A case study protocol

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