Conclusion
Delirium occurs frequently in
critically ill, older patients and is
associated with numerous adverse
outcomes during and after hospitalization.
The safety and efficacy of
antipsychotic medications in older
adults is questionable, and studies
raise the issue of whether this class of
medications is appropriate for treatment
of delirium in the ICU. Existing
evidence also suggests that the use of
benzodiazepines may further increase
the risk for delirium in critically ill older patients. These findings suggest
a need to provide ICU nurses
with alternatives to sedation that
will keep patients from becoming
delirious. Although a wide variety of
nonpharmacological interventions
to prevent and treat delirium in hospitalized
older adults have been
offered, these interventions have
not been tested in an ICU. Removal,
reversal, and recognition of the
underlying causes of delirium are
essential components in its treatment.
Critical care nurses who provide
care for older adults should use
all available resources to establish
an effective communication network
with the patients, the patients’ family members, and other health
care providers to achieve successful,
healthy outcomes for patients