What is delirium, and which assessment tool is commonly used in palliative care to screen for it?

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Multiple Choice

What is delirium, and which assessment tool is commonly used in palliative care to screen for it?

Delirium is an abrupt change in mental status characterized by a disturbance in awareness and a fluctuating course of attention and cognition. In palliative care this is especially important because it can signal reversible problems such as infection, dehydration, metabolic issues, or medication effects, and it causes significant distress for patients and families. The screen most commonly used at the bedside is the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit), with the CAM-ICU-ET variant used in some settings. These tools are quick and validated for patients who are nonverbal or intubated. They assess four features: acute onset or a fluctuating course, inattention, disorganized thinking, and altered level of consciousness. A delirium diagnosis is indicated when there is an acute or fluctuating change plus inattention and either disorganized thinking or altered consciousness. Delirium differs from chronic cognitive decline like dementia, which shows a gradual, persistent deficit without the same acute fluctuations. It’s also not a mood disorder or a seizure disorder, which have different clinical presentations.

Delirium is an abrupt change in mental status characterized by a disturbance in awareness and a fluctuating course of attention and cognition. In palliative care this is especially important because it can signal reversible problems such as infection, dehydration, metabolic issues, or medication effects, and it causes significant distress for patients and families.

The screen most commonly used at the bedside is the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit), with the CAM-ICU-ET variant used in some settings. These tools are quick and validated for patients who are nonverbal or intubated. They assess four features: acute onset or a fluctuating course, inattention, disorganized thinking, and altered level of consciousness. A delirium diagnosis is indicated when there is an acute or fluctuating change plus inattention and either disorganized thinking or altered consciousness.

Delirium differs from chronic cognitive decline like dementia, which shows a gradual, persistent deficit without the same acute fluctuations. It’s also not a mood disorder or a seizure disorder, which have different clinical presentations.

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