Delirium in Hospitalized Older Adults: Nursing Care with Clinical Reasoning

Abstract

Delirium is a geriatric syndrome, particularly among older adults experiencing acute illness and hospitalization. It has complex, multifactorial causes, which can be divided into two main groups: predisposing and precipitating factors. This condition involves an acute onset and fluctuation in consciousness, awareness, concentration, and physical function, often manifesting with non-specific signs and symptoms. Delirium is temporary and usually reversible, and it can be categorized as hyperactive, hypoactive, or mixed. Literature reviews support the preventability of delirium through several assessments, including history-taking, physical examinations, laboratory results, and cognitive assessment tools. Early detection and appropriate management are essential to prevent both short-term and long-term consequences for older adults, their families, and healthcare agencies. Caring for delirium in hospitalized older adults requires the cooperation of a multidisciplinary team, as well as family members. Nurses, as practitioners who provide continuous and direct care to older adults, should possess adequate knowledge and understanding of the causes, symptoms, and assessment tools related to delirium. This competence enables nurses to deliver both non-pharmacological and pharmacological management appropriately and effectively, ensuring individualized care aligned with each older patient’s condition.