Delirium is encountered frequently in Palliative Care, due to a multitude of possible causes. Should it be regarded as ‘normal’ in patients
who are actively dying? Decisions about whether to look for an underlying cause and whether to intervene can be difficult and need to be individualized. The validated instruments used to identify
and rate delirium were developed for use in neurology and psychiatry. How applicable are they to the palliative care population? What is the best way to support the family of a delirious patient
in Palliative Care?
This book is a detailed review of all aspects of delirium seen in Palliative Care. It includes discussions of the questions raised above,
and much more. The various chapters cover definitions and nomenclature, neuropathophysiology, incidence and prevalence, clinical features, diagnosis and differential diagnosis, and management.
Particularly useful is the critical review of the instruments used for identifying and rating delirium. The details of seven of the commonly used instruments are set out in the Appendices.
This is a useful and stimulating book that takes our thinking about the meaning and management of delirium one step further. A worthy addition
to the Palliative Care Service library.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(July 2003)
Author Information
Augusto Caraceni, Rehabilitation and Palliative Care Unit, National Cancer Institute, Milan, Italy.
Luigi Grassi, Department of Medical Disciplines,Section of Psychiatry, University of Ferrara, Italy.
Table of Contents
1. Delirium: historical concepts and current definitions 1
2. Pathophysiology 21
3. Epidemiology 32
4. Clinical phenomenology 42
5. Differential diagnosis 61
6. Frequent aetiologies 71
7. Frequent clinical subtypes - delirium in special populations 98
8. Diagnostic assessment 119
9. Management 131
10. Family issues 158
References
Appendices
