Delirium in palliative care

Abstract

Neuropsychiatric disorders are frequent in advanced cancer and other terminal illness situations. Sets up the delusion, and second Carlos Centeno as acute confusional state that derives from an organic brain dysfunction of multifactorial etiology. Depending on the authors, varies from 28% to 85%. Delirium is one of the most difficult symptoms to diagnose and treat, and also one that causes further deterioration of the quality of life of patients and their relationship with family, carers or support team. Their presence affects more difficulty in assessing pain, other symptoms or problems - constipation, urinary retention, fever, respiratory or urinary infections, dehydration, etc.., - By causing disruption in communication with the patient and prevent participation in decisions that concern their disease. Although an expected situation at the end of life can nevertheless be reversible or controllable in about 25-45% of the cases, so that in its approach must take into account this feature, individualizing up in each case, transmitting the family hope of reversibility. In advanced disease, manifested by delirium: cognitive, psychomotor behavior disorders with an acute or subacute facility, with fluctuations during the day, becoming worse for the night, and may adopt an overactive form (the most common) and underactive form. Delirium, usually multifactorial etiology, affects a range of intervention measures that pass by: therapy directed to the cause, intervention in the patient's behavior and the environment, family support and symptomatic treatment, mainly by making proper use of various types of neuroleptics, as well as other pharmacological interventions.