The delirium experience: what is the effect on patients, relatives and staff and what can be done to modify this?

• Published in: International journal of geriatric psychiatry 2013-08, Vol.28 (8), p.804-812
• Main Authors: Partridge, Judith SL, Martin, Finbarr C, Harari, Danielle, Dhesi, Jugdeep K
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Anxiety - etiology; Biological and medical sciences; Caregivers; Delirium; Delirium - psychology; delirium experience; Depression - etiology; distress; Emotional disorders; Families & family life; Family - psychology; General aspects; Geriatric psychiatry; Geriatrics; Health Personnel - psychology; Humans; information provision; Medical sciences; Mental health care; Mental Recall; Organic mental disorders. Neuropsychology; Psychiatry; psychological/psychiatric sequelae; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Qualitative Research; relatives; staff; Stress Disorders, Post-Traumatic - etiology; Stress, Psychological - etiology; Stress, Psychological - prevention & control
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.3900

Background Delirium is a common clinical syndrome with significant associated mortality, morbidity and financial cost. Less is understood about the experience of delirium for the patient, their family and staff involved in their care. Objective This synthesis draws on qualitative and quantitative literature examining different populations (patients, relatives and staff) in different clinical settings (intensive care units, surgery and hospice care) to provide a clinical summary of the delirium experience from the perspective of patients, relatives and staff. Design A literature search was conducted in Ovid, MEDLINE, Embase, PsychINFO, British Nursing Index and Archive and PubMed between 1980 and 2011 using the terms ‘delirium’ combined with ‘distress’, ‘recall’, ‘anxiety’, ‘depression’, ‘PTSD’, ‘experience’ and ‘patient education’. Articles were restricted to English language only. Results Evidence suggests that some patients recall delirium and that recollections are generally distressing. Distress may be greater in relatives witnessing delirium and is also reported in professional staff. This distress may result in longer‐term psychological sequelae. Remedial action, such as explanatory information to patients and their families, may reduce distress and psychological morbidity. Conclusions A better understanding of the experience and psychological consequences of delirium will inform the development of appropriate methods of providing support and information to those at risk of delirium and their families or carers. Copyright © 2012 John Wiley & Sons, Ltd.