Preventing Delirium at the End of Life: Lessons From Recent Research

Preservation of the ability to think clearly, in comfort, is a goal of end-of-life care. Recent research on delirium at the end of life suggests clinical strategies for prevention of cognitive impairment. Clinicians should consider early warnings of mild delirium such as impairment in attention and...

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Published inPrimary care companion to the Journal of clinical psychiatry Vol. 5; no. 2; pp. 62 - 67
Main Author Greenberg, Donna B.
Format Journal Article
LanguageEnglish
Published United States Physicians Postgraduate Press, Inc 01.04.2003
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CME
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Summary:Preservation of the ability to think clearly, in comfort, is a goal of end-of-life care. Recent research on delirium at the end of life suggests clinical strategies for prevention of cognitive impairment. Clinicians should consider early warnings of mild delirium such as impairment in attention and short-term memory by following the patient's ability to remember 3 words or to attend to digit span before the patient is disoriented. If cognitive impairment is noted, clinicians should pay attention to reversible causes. This article reviews clinical concerns about opiates, benzodiazepines, steroids, hepatic encephalopathy, timely use of neuroleptic medications, and caretaking strategies at home.
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Corresponding author and reprints: Donna B. Greenberg, M.D., Department of Psychiatry, Massachusetts General Hospital, WRN 605, 55 Fruit St., Boston, MA 02114 (e-mail: dgreenberg@partners.org).
ISSN:1523-5998