Managing Delirium in Patients at the End of Life: Resources and Support for Healthcare Professionals

Summary

• Delirium is a common but often underrecognized issue in patients at the end of life.
• Healthcare professionals can access a variety of resources to support them in managing delirium in these patients.
• These resources include guidelines, training programs, consult services, and interdisciplinary teams.

Introduction

Delirium is a serious and distressing complication that can occur in patients at the end of life. It is characterized by sudden changes in mental status, including confusion, disorientation, and agitation. Delirium can have a significant impact on patients’ quality of life and can complicate their care. Healthcare professionals who care for patients at the end of life must be prepared to recognize and manage delirium effectively. Fortunately, there are resources available to support them in this challenging task.

Guidelines

One valuable resource for healthcare professionals managing delirium in patients at the end of life is clinical practice guidelines. These guidelines provide evidence-based recommendations for the assessment and management of delirium, helping to ensure that patients receive high-quality care. Some key guidelines for delirium management include:

1. The National Institute for Health and Care Excellence (NICE) guidelines on delirium, which provide recommendations for the prevention, diagnosis, and management of delirium in all healthcare settings.
2. The American Geriatrics Society (AGS) Clinical Practice Guideline for Postoperative Delirium in Older Adults, which offers recommendations for the prevention and management of delirium in older patients undergoing surgery.

Training Programs

In addition to guidelines, healthcare professionals can benefit from participating in training programs focused on delirium management. These programs help to enhance professionals’ knowledge and skills in assessing and managing delirium, improving their ability to provide optimal care for patients at the end of life. Some examples of training programs that focus on delirium management include:

1. The Hospice and Palliative Nurses Association (HPNA) Delirium Toolkit, which offers online training modules and resources for healthcare professionals caring for patients with delirium at the end of life.
2. The Hospital Elder Life Program (HELP), which provides training and support for healthcare professionals in implementing delirium prevention and management strategies in hospitals.

Consult Services

Healthcare professionals caring for patients with delirium at the end of life can also benefit from access to consult services that provide expert guidance and support. These services can help professionals navigate complex cases of delirium and develop effective management plans. Some consult services that may be helpful for managing delirium in patients at the end of life include:

1. The Delirium Research Hub Consult Service, which offers virtual consultations with delirium experts to assist healthcare professionals in managing cases of delirium.
2. The American Delirium Society (ADS) Consult Service, which provides resources and support for healthcare professionals seeking assistance with delirium assessment and management.

Interdisciplinary Teams

Collaboration with interdisciplinary teams can also be an invaluable resource for healthcare professionals managing delirium in patients at the end of life. These teams bring together professionals from different disciplines, such as medicine, nursing, social work, and psychology, to develop comprehensive care plans that address the complex needs of patients with delirium. Interdisciplinary teams may include:

1. The palliative care team, which can provide expert symptom management and psychosocial support for patients with delirium at the end of life.
2. The geriatric consultation team, which specializes in caring for older adults with complex medical conditions, including delirium.

Conclusion

Managing delirium in patients at the end of life is a complex and challenging task, but healthcare professionals have access to a variety of resources to support them in this important work. Clinical practice guidelines, training programs, consult services, and interdisciplinary teams can all play a role in helping professionals provide high-quality care for patients with delirium. By utilizing these resources effectively, healthcare professionals can improve outcomes for patients at the end of life and ensure that they receive the best possible care.

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