Refractory delirium in palliative care sitting

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Igbal Abdelati MD, Sami Ayed Alshammary, MD*, Savithiri Ratnapalan MBBS,PhD, “Refractory delirium in palliative care sitting”, ijmhs, vol. 10, no. 01, pp. 777–784, Jan. 2020.
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Abstract

This paper describes the management of a 65 years old male patient
transferred to the palliative care ward from the Intensive Care Unit, with
brain metastasis and infarction admission, epilepsy, neurological dysfunction,
cognitive impairment and a history of previous delirium episodes. We
discuss four delirium assessment methods and possible collaborative
multidisciplinary approaches to manage persistent delirium in palliative care
patients.1.Agar M, Alici Y, and Breitbart (2015)W.17.5 Delirium. In In Oxford Textbook
of Palliative Medicine 5th edition. Cherny N, Fallon M, Kaasa S, Portenoy R, Currow D. Oxford University Press . pp 1092-1100
2.Hosker CM and Bennet MI. Delirium andagitation at the end of life. BMJ2016;353:i3085 doi: 10.1136/bmj.i3085
3.Cherny N, Fallon M, Kaasa S, PortenoyR, Currow D. Oxford Textbook of Palliative Medicine 5th edition. Oxford.Oxford University Press. 2015
4.Ryan K, Leonard M, Guerin S, et al.Validation of the confusion assessmentmethod in the palliative care setting.Palliat Med 2009;23(1):40-5
5.Wong CL, Holroyd-Leduc J, Simel DL,et al. Does this patient have delirium?:

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References

1.Agar M, Alici Y, and Breitbart (2015)W.17.5 Delirium. In In Oxford Textbook of Palliative Medicine 5th edition. Cherny N, Fallon M, Kaasa S, Portenoy R, Currow D. Oxford University Press . pp 1092-1100 2.Hosker CM and Bennet MI. Delirium andagitation at the end of life. BMJ2016;353:i3085 doi: 10.1136/bmj.i3085 3.Cherny N, Fallon M, Kaasa S, PortenoyR, Currow D. Oxford Textbook of Palliative Medicine 5th edition. Oxford.Oxford University Press. 2015 4.Ryan K, Leonard M, Guerin S, et al.Validation of the confusion assessmentmethod in the palliative care setting.Palliat Med 2009;23(1):40-5 5.Wong CL, Holroyd-Leduc J, Simel DL,et al. Does this patient have delirium?:value of bedside instruments. (review) JAMA 2010;304(7):779-86 6.Leonard MM, Nekolaichuk C, MeagherDJ, et al. Practical assessment of deliriumin palliative care. J Pain SymptomManage 2014;48:176-90.doi:10.1016/j.jpainsymman. 2013.10.024pmid:24766745. 7.Inouye SK, Charpentier PA.Precipitating factors for delirium inhospitalized elderly persons. Predictivemodel and interrelationship with baselinevulnerability. JAMA 1996;275:852-7.doi:10.1001/jama.1996.03530350034031pmid:8596223. 8.National Institute for Health and CareExcellence. Delirium: prevention,diagnosis and management. NICEguideline103. 2010. https://www.nice.org.uk/guidance/CG103?UNLID=71857637201581742332access date 16/2/2018 9.Cobb JL, Glantz MJ, Nicholas PK, et al.Delirium in patients with cancer at theend of life.Cancer Pract 2000;8:172-7.doi:10.1046/j.1523-5394.2000.84006.xpmid:11898256. 10.Twycross R and Wilcock A. Introducingpalliative care. 5th edition. Nottingham:palliativedrugs.com; 2016. 11.Adult Network Guidelineswww.book.pallcare.info (convulsions andseizures; anxiety, depression) date ofaccess 18/2/2018. 12.British Geriatrics Society and RoyalCollege of Physician(2006). Theprevention, diagnosis and management ofdelirium in older people. NationalGuidelines Available fromwww.rcplondon.au,uk date of access1.3.2018.

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References

1.Agar M, Alici Y, and Breitbart (2015)W.17.5 Delirium. In In Oxford Textbook
of Palliative Medicine 5th edition. Cherny N, Fallon M, Kaasa S, Portenoy R, Currow D. Oxford University Press . pp 1092-1100
2.Hosker CM and Bennet MI. Delirium andagitation at the end of life. BMJ2016;353:i3085 doi: 10.1136/bmj.i3085
3.Cherny N, Fallon M, Kaasa S, PortenoyR, Currow D. Oxford Textbook of Palliative Medicine 5th edition. Oxford.Oxford University Press. 2015
4.Ryan K, Leonard M, Guerin S, et al.Validation of the confusion assessmentmethod in the palliative care setting.Palliat Med 2009;23(1):40-5
5.Wong CL, Holroyd-Leduc J, Simel DL,et al. Does this patient have delirium?:value of bedside instruments. (review) JAMA 2010;304(7):779-86
6.Leonard MM, Nekolaichuk C, MeagherDJ, et al. Practical assessment of deliriumin palliative care. J Pain SymptomManage 2014;48:176-90.doi:10.1016/j.jpainsymman. 2013.10.024pmid:24766745.
7.Inouye SK, Charpentier PA.Precipitating factors for delirium inhospitalized elderly persons. Predictivemodel and interrelationship with baselinevulnerability. JAMA 1996;275:852-7.doi:10.1001/jama.1996.03530350034031pmid:8596223.
8.National Institute for Health and CareExcellence. Delirium: prevention,diagnosis and management. NICEguideline103. 2010. https://www.nice.org.uk/guidance/CG103?UNLID=71857637201581742332access date 16/2/2018
9.Cobb JL, Glantz MJ, Nicholas PK, et al.Delirium in patients with cancer at theend of life.Cancer Pract 2000;8:172-7.doi:10.1046/j.1523-5394.2000.84006.xpmid:11898256.
10.Twycross R and Wilcock A. Introducingpalliative care. 5th edition. Nottingham:palliativedrugs.com; 2016.
11.Adult Network Guidelineswww.book.pallcare.info (convulsions andseizures; anxiety, depression) date ofaccess 18/2/2018.
12.British Geriatrics Society and RoyalCollege of Physician(2006). Theprevention, diagnosis and management ofdelirium in older people. NationalGuidelines Available fromwww.rcplondon.au,uk date of access1.3.2018.

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