Nursing Care, Delirium, and Pain Management for the Hospitalized Older Adult

Delirium is a reversible cognitive disorder that has a rapid onset. Delirium risk factors include older age, severity of illness, poorer baseline functional status, comorbid medical conditions, and dementia. There are adverse consequences of delirium, including increased length of stay and increased mortality. Therefore, it is important for nurses to identify clients at risk and prevent and manage delirium in the hospitalized older client. Once high-risk clients are identified, prevention strategies may be used to reduce the incidence. Examples of prevention strategies include providing glasses and working hearing aids and effective pain management. This article discusses various assessment instruments that detect the presence of delirium. With this information, nurses are better equipped to evaluate the best assessment options for their work setting. Early detection is crucial to reduce the adverse consequences of delirium. Once a client is found to be experiencing delirium, a treatment plan can be established using both nonpharmacologic and pharmacologic interventions. In addition, the identification and the correction of etiologies of delirium can shorten the course of delirium.