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The evaluation and management of delirium among older persons
Authors:Flaherty Joseph H
Affiliation:a Geriatric Research, Education and Clinical Center, St Louis Veterans Affairs Medical Center, #1 Jefferson Barracks Road, St Louis, MO 63125, USA
b Division of Geriatrics, Department of Internal Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, Room M238, St Louis, MO 63104, USA
Abstract:This article reviews the pathophysiology, prevalence, incidence, and consequences of delirium, focusing on the evaluation of delirium, the published models of care for prevention in patients at risk of delirium, and management of patients for whom delirium is not preventable. Evidence on why physical restraints should not be used for patients with delirium is reviewed. Current available evidence on antipyschotics does not support the role for the general use in the treatment of delirium. An example of a restraint-free, nonpharmacologic management approach [called the TADA approach (tolerate, anticipate, and don't agitate)] is presented.
Keywords:Evaluation   Management   Delirium   Older persons
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