Outcomes in delirium: same but different

Abstract

Delirium has been associated with institutionalization, increased length of hospital stay, cognitive and functional decline and mortality. Research in the last thirty years has recognized that accurate diagnostic criteria allow for targeted interventions for those suffering from delirium. However, despite the advances made in understanding delirium, adverse outcomes persist. This article will first review how the evolution of diagnostic criteria has fostered improvements in the recognition of delirium and facilitated the development of therapeutic strategies. Second, we discuss how this foundation in approach to delirium has influenced outcomes and the evidence for causality. Finally, the candidate factors responsible for propagating adverse events are considered and future research direction outlined.

The role of advance care planning in end-of-life care for residents of aged care facilities

“…It would appear that this would have been an ideal situation for discussion and implementation of ACP in the RACF, particularly as Mrs K had openly discussed her wishes with Anne. It may well have precluded Mrs K's transfer to hospital, where she became delirious, a development not uncommon in hospitalised older persons (Renjel and Eeles 2014). In fact, evidence substantiates the benefits of persons remaining in their place of residence, citing familiarity, comfort, and continuity of care (Evans 2011;Allen et al 2003).…”