Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience
Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium supe...
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| Published in | Journal of psychosomatic research Vol. 79; no. 4; pp. 272 - 280 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Inc
01.10.2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-3999 1879-1360 1879-1360 |
| DOI | 10.1016/j.jpsychores.2015.06.012 |
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| Abstract | Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia.
Caregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1).
A total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience.
This study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia.
•Delirium superimposed on dementia is a highly distressing experience for caregivers and health care staff.•The distress level was moderate among caregivers and mild among health care staff.•Caregivers reported higher distress related to specific delirium symptoms.•Physiotherapists also reported higher distress related to delirium symptoms.•Different categories of caregivers’ and staff feelings were identified |
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| AbstractList | Abstract Objective Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia. Methods Caregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1). Results A total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience. Conclusions This study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia. Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia. Caregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1). A total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience. This study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia. •Delirium superimposed on dementia is a highly distressing experience for caregivers and health care staff.•The distress level was moderate among caregivers and mild among health care staff.•Caregivers reported higher distress related to specific delirium symptoms.•Physiotherapists also reported higher distress related to delirium symptoms.•Different categories of caregivers’ and staff feelings were identified Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia. Caregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1). A total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience. This study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia. Delirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia.OBJECTIVEDelirium superimposed on dementia is common and potentially distressing for patients, caregivers, and health care staff. We quantitatively and qualitatively assessed the experience of informal caregiver and staff (staff nurses, nurse aides, physical therapists) caring for patients with delirium superimposed on dementia.Caregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1).METHODSCaregivers' and staff experience was evaluated three days after delirium superimposed on dementia resolution (T0) with a standardized questionnaire (quantitative interview) and open-ended questions (qualitative interview); caregivers were also evaluated at 1-month follow-up (T1).A total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience.RESULTSA total of 74 subjects were included; 33 caregivers and 41 health care staff (8 staff nurses, 20 physical therapists, 13 staff nurse aides/health care assistants). Overall, at both T0 and T1, the distress level was moderate among caregivers and mild among health care staff. Caregivers reported, at both T0 and T1, higher distress related to deficits of sustained attention and orientation, hypokinesia/psychomotor retardation, incoherence and delusions. The distress of health care staff related to each specific item of the Delirium-O-Meter was relatively low except for the physical therapists who reported higher level of distress on deficits of sustained/shifting attention and orientation, apathy, hypokinesia/psychomotor retardation, incoherence, delusion, hallucinations, and anxiety/fear. The qualitative evaluation identified important categories of caregivers' and staff feelings related to the delirium experience.This study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia.CONCLUSIONSThis study provides information on the implication of the experience of delirium on caregivers and staff. The distress related to delirium superimposed on dementia underlines the importance of providing continuous training, support and experience for both the caregivers and health care staff to improve the care of patients with delirium superimposed on dementia. |
| Author | Bellelli, Giuseppe Meagher, David Voyer, Philippe Fick, Donna M. Morghen, Sara Inouye, Sharon K. Morandi, Alessandro Lucchi, Elena Santi, Rossana Trabucchi, Marco Turco, Renato Guerini, Fabio Gentile, Simona Schmitt, Eva M. |
| AuthorAffiliation | 2 Geriatric Research Group, Brescia 9 Department of Health Sciences, University of Milano-Bicocca and Geriatric Medicine, San Gerardo Hospital, Monza, Italy 6 Hebrew SeniorLife, Institute for Aging Research; Harvard Medical School, Boston, MA, USA 8 University of Tor Vergata, Rome, Italy, Rome 3 Graduate-entry Medical School, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland 1 Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona 7 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA 4 Faculty of Nursing sciences, Université Laval, Quebec City, Canada 5 College of Nursing, The Pennsylvania State University, Boston, MA, USA |
| AuthorAffiliation_xml | – name: 5 College of Nursing, The Pennsylvania State University, Boston, MA, USA – name: 4 Faculty of Nursing sciences, Université Laval, Quebec City, Canada – name: 3 Graduate-entry Medical School, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland – name: 9 Department of Health Sciences, University of Milano-Bicocca and Geriatric Medicine, San Gerardo Hospital, Monza, Italy – name: 1 Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona – name: 8 University of Tor Vergata, Rome, Italy, Rome – name: 2 Geriatric Research Group, Brescia – name: 7 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA – name: 6 Hebrew SeniorLife, Institute for Aging Research; Harvard Medical School, Boston, MA, USA |
| Author_xml | – sequence: 1 givenname: Alessandro surname: Morandi fullname: Morandi, Alessandro email: morandi.alessandro@gmail.com organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 2 givenname: Elena surname: Lucchi fullname: Lucchi, Elena email: elena.lucchi@ancelle.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 3 givenname: Renato surname: Turco fullname: Turco, Renato email: renatoturco@virgilio.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 4 givenname: Sara surname: Morghen fullname: Morghen, Sara email: sara.morghen@ancelle.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 5 givenname: Fabio surname: Guerini fullname: Guerini, Fabio email: fabio.guerini@ancelle.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 6 givenname: Rossana surname: Santi fullname: Santi, Rossana email: rossana.santi@ancelle.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 7 givenname: Simona surname: Gentile fullname: Gentile, Simona email: simona.gentile@ancelle.it organization: Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy – sequence: 8 givenname: David surname: Meagher fullname: Meagher, David email: david.meagher@ul.ie, dmf21@psu.edu organization: Graduate-entry Medical School, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland – sequence: 9 givenname: Philippe surname: Voyer fullname: Voyer, Philippe email: philippe.voyer@fsi.ulaval.ca organization: Faculty of Nursing Sciences, Université Laval, Quebec City, Canada – sequence: 10 givenname: Donna M. surname: Fick fullname: Fick, Donna M. organization: College of Nursing, The Pennsylvania State University, USA – sequence: 11 givenname: Eva M. surname: Schmitt fullname: Schmitt, Eva M. email: EvaSchmitt@hsl.harvard.edu organization: Hebrew SeniorLife, Institute for Aging Research, Harvard Medical School, USA – sequence: 12 givenname: Sharon K. surname: Inouye fullname: Inouye, Sharon K. email: sharoninouye@hsl.harvard.edu organization: Hebrew SeniorLife, Institute for Aging Research, Harvard Medical School, USA – sequence: 13 givenname: Marco surname: Trabucchi fullname: Trabucchi, Marco email: trabucchi.m@grg-bs.it organization: Geriatric Research Group, Brescia, Italy – sequence: 14 givenname: Giuseppe surname: Bellelli fullname: Bellelli, Giuseppe email: giuseppe.bellelli@unimib.it organization: Geriatric Research Group, Brescia, Italy |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26286892$$D View this record in MEDLINE/PubMed |
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| Publisher_xml | – name: Elsevier Inc |
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| SubjectTerms | Caregivers - psychology Caregivers' experience Cohort Studies Delirium - nursing Delirium - psychology Delirium superimposed on dementia Dementia - nursing Dementia - psychology Female Humans Male Middle Aged Patient Care Team - standards Prospective Studies Psychiatry Stress Surveys and Questionnaires |
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| Title | Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience |
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