[Delirium in palliative care].
Delirium has an abrupt onset and represents an emergency. The symptoms of delirium include reduced consciousness, cognitive failure and altered psychomotor activity. In this paper, we present delirium in palliative care based on a literature review and clinical experience. Delirium is the second most common psychiatric condition in cancer patients in general. The exact prevalence in palliative care is unknown. Several factors can precipitate a delirium. The most common factors are probably opioids, dehydration and metabolic disturbances. The assessment must be balanced towards the patient's life expectancy and aims at establishing the diagnosis and identifying precipitating factors. The diagnosis of delirium is easy for those familiar with the diagnostic criteria. The abrupt change in the patients' mental status is the key to correct diagnosis. The assessment can include instruments used in semi-structured interviews. Delirium can probably be prevented. The type and amount of treatment depends upon the patient's life expectancy. Causal treatment is a goal unless the delirium is part of the dying process. Symptom control is generally achieved by haloperidol and regulation of stimuli.
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Jon Håvard
JH
Avdeling for atferdsfag, Institutt for medisinske basalfag, Universitetet i Oslo, Postboks 1111 Blindern, 0317 Oslo.
Hjermstad
Marianne Jensen
MJ
Kaasa
Stein
S
D000701:Analgesics, Opioid / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D010166:Palliative Care; D013727:Terminal Care
D000701:Analgesics, Opioid; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives