Perspectives on the Delirium Experience and Its Burden: Common Themes among Older Patients, Their Family Caregivers, and Nurses

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

Research output: Contribution to journalArticle

Abstract

Background and Objectives While there are qualitative studies examining the delirium-related experiences of patients, family caregivers, and nurses separately, little is known about common aspects of delirium burden among all three groups. We describe common delirium burdens from the perspectives of patients, family caregivers, and nurses. Research Design and Methods We conducted semistructured qualitative interviews about delirium burden with 18 patients who had recently experienced a delirium episode, with 16 family caregivers, and with 15 nurses who routinely cared for patients with delirium. We recruited participants from a large, urban teaching hospital in Boston, Massachusetts. Interviews were recorded and transcribed. We used interpretive description as the approach to data analysis. Results We identified three common burden themes of the delirium experience: Symptom Burden (Disorientation, Hallucinations/Delusions, Impaired Communication, Memory Problems, Personality Changes, Sleep Disturbances); Emotional Burden (Anger/Frustration, Emotional Distress, Fear, Guilt, Helplessness); and Situational Burden (Loss of Control, Lack of Attention, Lack of Knowledge, Lack of Resources, Safety Concerns, Unpredictability, Unpreparedness). These burdens arise from different sources among patients, family caregivers, and nurses, with markedly differing perspectives on the burden experience. Discussion and Implications Our findings advance the understanding of common burdens of the delirium experience for all groups and offer structure for instrument development and distinct interventions to address the burden of delirium as an individual or group experience. Our work reinforces that no one group experiences delirium in isolation. Delirium is a shared experience that will respond best to systemwide approaches to reduce associated burden.

Original languageEnglish (US)
Pages (from-to)327-337
Number of pages11
JournalGerontologist
Volume59
Issue number2
DOIs
StatePublished - Mar 14 2019

Keywords

  • Burden
  • Confusion
  • Delirium
  • Hospitalization
  • Severity

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'Perspectives on the Delirium Experience and Its Burden: Common Themes among Older Patients, Their Family Caregivers, and Nurses'. Together they form a unique fingerprint.

  • Cite this

    Schmitt, E. M., Gallagher, J., Albuquerque, A., Tabloski, P., Lee, H. J., Gleason, L., Weiner, L. S., Marcantonio, E. R., Jones, R. N., Inouye, S. K., & Schulman-Green, D. (2019). Perspectives on the Delirium Experience and Its Burden: Common Themes among Older Patients, Their Family Caregivers, and Nurses. Gerontologist, 59(2), 327-337. https://doi.org/10.1093/geront/gnx153