Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Mar;26(3):291-300.
doi: 10.1002/pon.4140. Epub 2016 May 1.

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

Anne M Finucane  1 , Jean Lugton  1 , Catriona Kennedy  2 , Juliet A Spiller  1
Affiliations
Review

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

Anne M Finucane et al. Psychooncology. 2017 Mar.

Abstract

Objectives: To explore the experiences of caregivers of terminally ill patients with delirium, to determine the potential role of caregivers in the management of delirium at the end of life, to identify the support required to improve caregiver experience and to help the caregiver support the patient.

Methods: Four electronic databases were searched-PsychInfo, Medline, Cinahl and Scopus from January 2000 to July 2015 using the terms 'delirium', 'terminal restlessness' or 'agitated restlessness' combined with 'carer' or 'caregiver' or 'family' or 'families'. Thirty-three papers met the inclusion criteria and remained in the final review.

Results: Papers focused on (i) caregiver experience-distress, deteriorating relationships, balancing the need to relieve suffering with desire to communicate and helplessness versus control; (ii) the caregiver role-detection and prevention of delirium, symptom monitoring and acting as a patient advocate; and (iii) caregiver support-information needs, advice on how to respond to the patient, interventions to improve caregiver outcomes and interventions delivered by caregivers to improve patient outcomes.

Conclusion: High levels of distress are experienced by caregivers of patients with delirium. Distress is heightened because of the potential irreversibility of delirium in palliative care settings and uncertainty around whether the caregiver-patient relationship can be re-established before death. Caregivers can contribute to the management of patient delirium. Additional intervention studies with informational, emotional and behavioural components are required to improve support for caregivers and to help the caregiver support the patient. Reducing caregiver distress should be a goal of any future intervention.© 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Keywords: cancer; caregiver; delirium; hospice; oncology; palliative.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram illustrating the search strategy
Figure 2
Figure 2
Themes identified from the literature review
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hosie A, Davidson PM, Agar M, Sanderson CR, Phillips J. Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: a systematic review. Palliat Med 2013;27(6):486–498. - PubMed
    1. Bush SH, Bruera E. The assessment and management of delirium in cancer patients. Oncologist 2009;14(10):1039–1049. - PubMed
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (5th edn.), American Psychiatric Association: Washington, DC, 2013.
    1. Partridge JS, Martin FC, Harari D, Dhesi JK. The delirium experience: what is the effect on patients, relatives and staff and what can be done to modify this? Int J Geriatr Psychiatry 2013;28(8):804–812. - PubMed
    1. O'Malley G, Leonard M, Meagher D, O'Keeffe ST. The delirium experience: a review. J Psychosom Res 2008;65(3):223–228. - PubMed
-