What is Terminal Delirium?

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Introduction
Terminal delirium is a potentially reversible confusional state that occurs in clients nearing death with advanced illnesses. Delirium frequently has a physiologic cause which leads to cognitive impairment (Potter & Perry, 2014). There are many different risk factors related to terminal delirium; ranging from dehydration to metabolic imbalances. If a terminal patient develops the condition, they will start to have behaviours such as restlessness and agitation. Many studies have been completed which show a prevalence of delirium in terminal patients, but unfortunately it frequently goes unnoticed. Recently there have been more attempts to educate health care professionals on the symptoms of delirium and more treatments are becoming available.
Risk Factors
In 2012, the Journal of Palliative Medicine published a chart review focusing on delirium risk factors for terminal patients with cancer. Delirium was observed in 42% of the subjects, and the mean age of the group that screened positive was higher than the group that did not have delirium. According to the results of this study, the male gender and a positive smoking history also appeared to be a common factor in those with delirium. In a terminally ill client’s last days, up to 83% experienced delirium. In most clients, terminal delirium usually began around the sixth day before death. Nagase et al. (2012) suggests that “In the future, it is necessary to separate terminal patients with cancer into high- and low-risk groups according to their risk factors.” By doing this nurses will be able to adjust their care for exactly what the patient needs (Nagase et al., 2012).
In 2010, Keeley released a review that says if patient’s have a terminal illness, up to 88% will ex...

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.... American Family Physician, 81(10), 1260
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