Developing guidelines on the assessment and treatment of delirium in older adults at the end of life

Susan Brajtman, David Wright, David B Hogan, Pierre Allard, Venera Bruto, Deborah Burne, Laura Gage, Pierre R Gagnon, Cheryl A Sadowski, Sherri Helsdingen, Kimberley Wilson, Susan Brajtman, David Wright, David B Hogan, Pierre Allard, Venera Bruto, Deborah Burne, Laura Gage, Pierre R Gagnon, Cheryl A Sadowski, Sherri Helsdingen, Kimberley Wilson

Abstract

Background and purpose: Delirium at the end of life is common and can have serious consequences on an older person's quality of life and death. In spite of the importance of detecting, diagnosing, and managing delirium at the end of life, comprehensive clinical practice guidelines (CPG) are lacking. Our objective was to develop CPG for the assessment and treatment of delirium that would be applicable to seniors receiving end-of-life care in diverse settings.

Methods: Using as a starting point the 2006 Canadian Coalition for Seniors' Mental Health CPG on the assessment and treatment of delirium, a team of palliative care researchers and clinicians partnered with members of the original guideline development group to adapt the guidelines for an end-of-life care context. This process was supported by an extensive literature review. The final guidelines were reviewed by external experts.

Results: Comprehensive CPG on the assessment and treatment of delirium in older adults at the end of life were developed and can be downloaded from http://www.ccsmh.ca.

Conclusions: Further research is needed on the implementation and evaluation of these adapted delirium guidelines for older patients receiving end-of-life care in various palliative care settings.

Keywords: Delirium; end of life; evidence-based practice; guidelines; older adults; palliative care.

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