Family and healthcare staff’s perception of delirium

Purpose: To review the available literature regarding delirium experiences of family caregivers and healthcare staff, to discuss how caregivers and staff perception can increase delirium detection and to summarize how to address the needs of family caregivers and healthcare providers in delirium care. Methods: “State of the science” paper. Results: High levels of caregiver stress are associated with delirium, although sources and features of burden differ according to background health status of patients, i.e. older subjects, with or without dementia, or terminal neoplastic disease. Family observation of cognitive changes is key for delirium detection, especially when dementia coexists, and is included in available delirium detection instruments. Healthcare staff experiences a high level of burden associated with delirium care, but often does not recognize delirium according to literature. An interprofessional healthcare staff education can improve attitudes towards delirium and increase delirium awareness, although intervention studies are still limited. Flexible visiting time is important to reduce family burden, although it needs appropriate staff training and work organization to avoid the risk of increased nurse burn-out. Conclusion: Delirium is a stressful event not only for patients but also for family caregivers and healthcare staff, especially nurses. Recording the observations of family members and healthcare staff can help in delirium detection. Staff education is crucial to reduce the burden of professional and family caregivers.