Distress in Family Members of Patients With Delirium in an Acute Palliative Care Unit – A Cross-Sectional Survey Study

Abstract

Background

Delirium is prevalent in Palliative Care patients and often induces distress in family members. Improving knowledge in this field will enable a more efficient approach to this problem, thereby helping patients and their families.

Aim

To evaluate the distress in family members of patients with delirium hospitalized in an Acute Palliative Care Unit (APCU).

Methodology

An anonymous survey was applied to caregivers 3 days after the identification of delirium. Validated instruments were used to identify the symptoms perceived by family members and their level of distress related to the delirium episode.

Results

Seventy caregivers (of 48 patients) were included; the patients had a median survival of 12 days. Family members recognized the signs of delirium, with nearly 80% reporting severe distress. Younger caregiver age (P < 0.05), higher delirium severity (P < 0.01), hyperactive delirium subtype (P < 0.05) and survival (P < 0.001) were strongly associated with severe distress. In the multivariate analysis, only survival maintained statistical significance (P < 0.01).

Conclusion

The severe distress experienced by caregivers underscores the need for a family-centered approach to prevent and support their suffering. Our results highlight the role of family in the recognition of delirium, working alongside the therapeutic team. Future research should provide longer follow-up of carers’ distress, compare family members of patients with and without delirium and similar survival rates, and evaluate the impact of communication on the distress experienced by these families.