Adult family member experiences during an older loved one's delirium: a narrative literature review

Day, Jenny; Higgins, Isabel

doi:10.1111/jocn.12771

Cited by 29 publications

(45 citation statements)

References 27 publications

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“…24–26 A recent review has additionally underlined how there is some understanding of delirium experience in palliative care settings but the lack of knowledge on this topic is even grater in acute care or long-term care settings. 27 In fact there are few studies conducted specifically in older patients admitted to in specialty delirium unit, acute care wards, adult day care centers. 28–30 Specifically Bull and colleagues 29 reported a low level of distress of informal caregivers of patients with delirium attending an adult day care center.…”

Section: Introductionmentioning

confidence: 99%

Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience

Morandi

Lucchi

Turco

et al. 2015

Journal of Psychosomatic Research

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Objective Delirium superimposed on dementia (DSD) 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 DSD. Methods Caregivers’ and staff experience was evaluated three days after DSD 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, 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 DSD 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.

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Section: Introductionmentioning

confidence: 99%

Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience

Morandi

Lucchi

Turco

et al. 2015

Journal of Psychosomatic Research

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“…These changes in perceptual reality and ways of behaving are often incongruent with the person family members know, making the older person seem ‘strange’ and ‘unfamiliar’ (Stenwall et al . , Day & Higgins ,b). Delirium's abrupt onset (Gupta et al .…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative research exploring the experiences of family members during their older loved one's delirium shows that the changes in the older person's demeanour render them unfamiliar, and absent or lost (Stenwall et al . , Day , Day & Higgins ,b). Absence and unfamiliarity, together with the accompanying distress family members’ experience (Breitbart et al .…”

Section: Introductionmentioning

confidence: 99%

Mum's absence(s): conceptual insights into absence as loss during a loved one's delirium

Day

Higgins

2016

Journal of Clinical Nursing

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Conceptualisations of absence enhance understandings of family distress and needs during their older loved one's delirium. The potential for family members to experience their loved one's absence during delirium, a nondeath loss, needs to be considered by healthcare staff. Family experiences of absence during delirium need to be recognised by healthcare staff, acknowledged as a potential source of distress, and considered when involving family in the older person's care. Nurses are ideally placed to respond compassionately and provide appropriate family member re-assurance, support and information during delirium. Information should include possible impacts on family and coping strategies.

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“…Family members are particularly impacted because these changes are sudden, unanticipated, and uncharacteristic for their older person; their behaviors are suddenly out of character and might seem bizarre. Indeed, they seem to inhabit a different reality (Stenwall et al, ; Day & Higgins, ,b). The changes family members encounter appear from “nowhere” and render their loved one “unfamiliar”, “absent”, or “lost” (Andersson et al, ; Stenwall et al, ; Day & Higgins, ,b).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, they seem to inhabit a different reality (Stenwall et al, ; Day & Higgins, ,b). The changes family members encounter appear from “nowhere” and render their loved one “unfamiliar”, “absent”, or “lost” (Andersson et al, ; Stenwall et al, ; Day & Higgins, ,b). In order to more fully understand the impact of delirium from the perspective of the family members of an older person with delirium, van Manen's () suggestion to search for and contemplate a range of lived experience materials was used in a phenomenological study (Day & Higgins, ).…”

Section: Introductionmentioning

confidence: 99%

Reflexivity and exploring the meaning of delirium through media depictions: Methodological insights from a phenomenological study

Day

Higgins

2016

Nursing & Health Sciences

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In the course of a phenomenological study that explored the experiences of family members during their older loved one's delirium, a range of delirium experiences depicted in artistic, creative, and linguistic media were reviewed. The search for, and compilation of, media sources for reflection during data analysis is described in this paper. In doing so, the researcher reveals how attentiveness and openness to varied depictions of lived experiences, as well as a valuing attitude toward challenging subjective perspectives, can enhance researcher reflexivity and appreciation of interpretive meanings. Turning to media depictions of delirium offered alternative perspectives on the experience. It challenged the researcher's assumptions, enhanced phenomenological reflection, promoted critique of evolving interpretations, and suggested meanings that might not have otherwise been realized. The approach used is a potent, although often overlooked, way to differentiate the nature of phenomena shared through lived experience data. Media-based methods and their use in phenomenology continue to be explored. Illustrations of how to integrate media sources, as well as discussion about the benefits and alternatives to more common uses, are needed.

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Adult family member experiences during an older loved one's delirium: a narrative literature review

Abstract: The distress family members experience, the impact of losing connection to their loved one, and the difficulty family face in sustaining hope for their loved one's return needs to be recognised and addressed by health care staff, particularly nurses, during the older person's care.

Cited by 29 publications

References 27 publications

Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience

Delirium superimposed on dementia: A quantitative and qualitative evaluation of informal caregivers and health care staff experience

Mum's absence(s): conceptual insights into absence as loss during a loved one's delirium

Reflexivity and exploring the meaning of delirium through media depictions: Methodological insights from a phenomenological study

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