Significance of General Practitioners and Nurses Diagnostic Skills in Managing Delirium in Elderly Patients

Delirium consists of a specific impairment of consciousness which occurs in elderly patients due to the physiological deterioration of adaptive abilities and adverse effects of various stimuli. The incidence of delirium varies between reviewed populations and may be underestimated due to diagnostic difficulties, the specificity of geriatric conditions and insufficient knowledge among healthcare providers. Delirium is often confused with the behavioral and psychological symptoms of dementia (BPSD), depression and disorders secondary to “geriatric giants” or somatic illnesses. The diagnostic criteria of delirium are listed by the authors of ICD- 10 and DSM classifications. For general practitioners and nurses, proper diagnosis of delirium in elderly patients is a challenging process. Diagnosing delirium by non-qualified healthcare providers is facilitated by numerous psychometric and specialist tools and scales. The most common are: CAM – the Confusion Assessment Method, MDAS – the Memorial Delirium Assessment Scale; DOSS – the Delirium Observation Screening Scale and the recently verified tool 4AT–the rapid assessment test for delirium. Proper diagnosis of delirium warrants optimization of care and stress reduction by formal and informal caregivers.

Keywords: Delirium; Dementia; Management of delirium; Assessment tools for delirium