JAMDA
Volume 10, Issue 5 , Pages 330-334 , June 2009

Documentation and Management of Words Associated With Delirium Among Elderly Patients in Postacute Care: A Pilot Investigation

  • Alessandro Morandi, MD

      Affiliations

    • Center for Health Services Research, Vanderbilt Medical Center, Nashville, TN
    • Department of Internal Medicine and Geriatrics, Poliambulanza Hospital, Brescia, Italy
    • Geriatric Research Group, Brescia, Italy
    • Center for Quality Aging, Vanderbilt University, Nashville, TN
    • Corresponding Author InformationAddress correspondence to Alessandro Morandi, MD, Center for Health Service Research, Vanderbilt University, 1215 21st Avenue South Nashville, MCE, Nashville, TN 37205.
    • ,
  • Laurence M. Solberg, MD

      Affiliations

    • Center for Quality Aging, Vanderbilt University, Nashville, TN
    • Section of Geriatrics, Department of Internal Medicine and Public Health, Vanderbilt University School of Medicine, Nashville, TN
    • VA Tennessee Valley Health System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN
    • ,
  • Ralf Habermann, MD

      Affiliations

    • Center for Quality Aging, Vanderbilt University, Nashville, TN
    • VA Tennessee Valley Health System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN
    • ,
  • Patrick Cleeton

      Affiliations

    • Center for Quality Aging, Vanderbilt University, Nashville, TN
    • ,
  • Emily Peterson

      Affiliations

    • Center for Quality Aging, Vanderbilt University, Nashville, TN
    • ,
  • E. Wesley Ely, MD, MPH

      Affiliations

    • Center for Health Services Research, Vanderbilt Medical Center, Nashville, TN
    • VA Tennessee Valley Health System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN
    • Division of Allergy/Pulmonary/Critical Care Medicine, Vanderbilt Medical Center, Nashville, TN
    • ,
  • John Schnelle, PhD

      Affiliations

    • Center for Quality Aging, Vanderbilt University, Nashville, TN

References 

  1. Kauh B, Polak T, Hazelett S, et al. A pilot study: Post-acute geriatric rehabilitation versus usual care in skilled nursing facilities. J Am Med Dir Assoc. 2005;6:321–326
  2. Young J, Green J, Forster A, et al. Postacute care for older people in community hospitals: a multicenter randomized, controlled trial. J Am Geriatr Soc. 2007;55:1995–2002
  3. Marcantonio ER, Simon SE, Bergmann MA, et al. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003;51:4–9
  4. Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. Gerontol A Biol Sci Med Sci. 2003;58:M441–M445
  5. Marcantonio ER, Kiely DK, Simon SE, et al. Outcomes of older people admitted to postacute facilities with delirium. J Am Geriatr Soc. 2005;53:963–969
  6. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med 199015;113:941–948.
  7. Kiely DK, Jones RN, Bergmann MA, et al. Association between delirium resolution and functional recovery among newly admitted postacute facility patients. J Gerontol A Biol Sci Med Sci. 2006;61:204–208
  8. Bellelli G, Frisoni GB, Turco R, et al. Delirium superimposed on dementia predicts 12-month survival in elderly patients discharged from a postacute rehabilitation facility. J Gerontol A Biol Sci Med Sci. 2007;62:1306–1309
  9. Kakuma R, du Fort GG, Arsenault L, et al. Delirium in older emergency department patients discharged home: Effect on survival. J Am Geriatr Soc. 2003;51:443–450
  10. Hustey FM, Meldon SW. The prevalence and documentation of impaired mental status in elderly emergency department patients. Ann Emerg Med. 2002;39:248–253
  11. Inouye SK, Leo-Summers L, Zhang Y, et al. A chart-based method for identification of delirium: Validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc. 2005;53:312–318
  12. Pisani MA, Araujo KL, Van Ness PH, et al. A research algorithm to improve detection of delirium in the intensive care unit. Crit Care. 2006;10:R121
  13. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286:2703–2710
  14. Morris JN, Fries BE, Mehr DR, et al. MDS Cognitive Performance Scale. J Gerontol. 1994;49:M174–M182
  15. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619
  16. Morris JN, Fries BE, Morris SA. Scaling ADLs within the MDS. J Gerontol A Biol Sci Med Sci. 1999;54:M546–M553
  17. Voyer P, Cole MG, McCusker J, et al. Accuracy of nurse documentation of delirium symptoms in medical charts. Int J Nurs Pract. 2008;14:165–177
  18. Flaherty JH, Rudolph J, Shay K, et al. Delirium is a serious and under-recognized problem: Why assessment of mental status should be the sixth vital sign. J Am Med Dir Assoc. 2007;8:273–275
  19. Steis MR, Fick DM. Are nurses recognizing delirium? A systematic review. J Gerontol Nurs. 2008;34:40–48
  20. Inouye SK, Bogardus ST, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340:669–676

 Dr. Ely has received research grants from the National Institute of Health. (AG027472-01A1) and VA-Meritgrant. The other authors report no financial disclosures.

PII: S1525-8610(09)00079-6

doi: 10.1016/j.jamda.2009.02.002

JAMDA
Volume 10, Issue 5 , Pages 330-334 , June 2009

Article Tools