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Delirium: Evaluation and Management

  • Geriatric Rehabilitation (P Kortebein, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Delirium is associated with high morbidity, mortality and healthcare costs, and longer inpatient hospital length of stays. The purpose of this review is to summarize the most recent evidence pertaining to the recognition, prevention, and management of delirium to help guide clinicians to make evidence-based decisions in patient care.

Recent Findings

Delirium is best managed with a multicomponent strategy using standardized tools for early recognition, such as the Confusion Assessment Method (CAM), non-pharmacologic interventions including restoration of the natural sleep-wake cycle with environmental management of light and noise, facilitating early mobility, and providing assistive devices such as eyeglasses and hearing aids. Medical optimization includes recognizing and treating medical problems, ensuring adequate nutrition, avoiding excessive testing and lines/catheters, and avoiding polypharmacy. Despite widespread use, there are insufficient data to support the use of antipsychotics to prevent or treat delirium.

Summary

A multicomponent strategy using a team-based approach to delirium recognition, prevention, and management employed consistently can improve patient care while reducing healthcare costs.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. University of Rochester Medical Center, Rochester, NY, USA

    Thomas V. Caprio, Eric J. Morrison & Kanakadurga R. Poduri

  2. Rochester, USA

    Thomas V. Caprio

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  1. Thomas V. Caprio
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  2. Eric J. Morrison
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  3. Kanakadurga R. Poduri
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Correspondence to Thomas V. Caprio.

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Caprio, T.V., Morrison, E.J. & Poduri, K.R. Delirium: Evaluation and Management. Curr Phys Med Rehabil Rep 7, 134–140 (2019). https://doi.org/10.1007/s40141-019-00223-w

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