Alessandro Morandi1, Elena Lucchi2, Renato Turco3, Sara Morghen4, Fabio Guerini5, Rossana Santi6, Simona Gentile7, David Meagher8, Philippe Voyer9, Donna M Fick10, Eva M Schmitt11, Sharon K Inouye12, Marco Trabucchi13, Giuseppe Bellelli14. 1. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: morandi.alessandro@gmail.com. 2. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: elena.lucchi@ancelle.it. 3. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: renatoturco@virgilio.it. 4. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: sara.morghen@ancelle.it. 5. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: fabio.guerini@ancelle.it. 6. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: rossana.santi@ancelle.it. 7. Department of Rehabilitation and Aged Care of the Ancelle Hospital, Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: simona.gentile@ancelle.it. 8. Graduate-entry Medical School, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland. Electronic address: david.meagher@ul.ie. 9. Faculty of Nursing Sciences, Université Laval, Quebec City, Canada. Electronic address: philippe.voyer@fsi.ulaval.ca. 10. College of Nursing, The Pennsylvania State University, USA. 11. Hebrew SeniorLife, Institute for Aging Research, Harvard Medical School, USA. Electronic address: EvaSchmitt@hsl.harvard.edu. 12. Hebrew SeniorLife, Institute for Aging Research, Harvard Medical School, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: sharoninouye@hsl.harvard.edu. 13. Geriatric Research Group, Brescia, Italy; University of Tor Vergata, Rome, Rome, Italy. Electronic address: trabucchi.m@grg-bs.it. 14. Geriatric Research Group, Brescia, Italy; Department of Health Sciences, University of Milano-Bicocca and Geriatric Medicine, San Gerardo Hospital, Monza, Italy; Milan center for Neuroscience (Neuro-Mi), Milan, Italy. Electronic address: giuseppe.bellelli@unimib.it.
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.
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.
Authors: Gary Epstein-Lubow; Brandon Gaudiano; Ellen Darling; Mathew Hinckley; Geoffrey Tremont; Robert Kohn; Louis J Marino; Stephen Salloway; Renée Grinnell; Ivan W Miller Journal: Am J Geriatr Psychiatry Date: 2012-09 Impact factor: 4.105
Authors: S A Zwijsen; A Kabboord; J A Eefsting; C M P M Hertogh; A M Pot; D L Gerritsen; M Smalbrugge Journal: Int J Geriatr Psychiatry Date: 2013-08-20 Impact factor: 3.485
Authors: A Morandi; D Davis; J K Taylor; G Bellelli; B Olofsson; S Kreisel; A Teodorczuk; B Kamholz; W Hasemann; J Young; M Agar; S E de Rooij; D Meagher; M Trabucchi; A M MacLullich Journal: Int Psychogeriatr Date: 2013-08-20 Impact factor: 3.878
Authors: Eva M Schmitt; Jacqueline Gallagher; Asha Albuquerque; Patricia Tabloski; Hyo Jung Lee; Lauren Gleason; Lauren S Weiner; Edward R Marcantonio; Richard N Jones; Sharon K Inouye; Dena Schulman-Green Journal: Gerontologist Date: 2019-03-14
Authors: Giuseppe Bellelli; Alessandro Morandi; Simona G Di Santo; Andrea Mazzone; Antonio Cherubini; Enrico Mossello; Mario Bo; Angelo Bianchetti; Renzo Rozzini; Ermellina Zanetti; Massimo Musicco; Alberto Ferrari; Nicola Ferrara; Marco Trabucchi Journal: BMC Med Date: 2016-07-18 Impact factor: 8.775
Authors: Alessandro Morandi; Jin H Han; David Meagher; Eduard Vasilevskis; Joaquim Cerejeira; Wolfgang Hasemann; Alasdair M J MacLullich; Giorgio Annoni; Marco Trabucchi; Giuseppe Bellelli Journal: J Am Med Dir Assoc Date: 2016-06-23 Impact factor: 4.669