| |
Frequency
of Delirium
During recent
years, a number of authors have documented that delirium is one
of the most frequent neuropsychiatric complications in patients
with advanced cancer (Breitbart
et al.,1995) (Stiefel
and Holland, 1991a).
- Approximately
80% of cancer patients may have delirium near death (Massie
et al., 1983).
- In a recent
prospective series of 104 eligiblie patients with advanced cancer
consecutively admitted to a tertiary palliative care unit, delirium
was present in 42% on admission and developed in 45% of the
remaining patients (Lawlor
et al., 2000a).
- Delirium
was present in 88% of patients who died and patients with delirium
had poorer survival rates than controls (Lawlor
et al., 2000a).
- The diagnosis
of delirium has been shown to significantly worsen life expectancy
in advanced cancer patients (Caraceni
et al., 2000).
Distress
Caused By Delirium
Delirium is
a distressing symptom for patients, family members and staff (Stiefel
and Holland, 1991a; Bruera,
1991). Families find changes in their relative’s mental status
one of the most distressing parts of caregiving. It interferes
with important communication between patients and their family
and prevents patient’s participation in treatment decisions; it
also makes the assessment of other symptoms more difficult. The
presence of agitated delirium has been shown to result in overestimation
of pain and increased administration of analgesics by nursing
and medical staff, and it significantly increases the likelihood
of problematic conflict between family members and staff (Bruera
et al.,1992a).
|