The Development of a Care Model for Elderly Patients with Delirium-like Symptoms in General Hospitals

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This research aims at developing an acute care model for elderly patients hospitalized with delirium-like symptoms. The research was carried out in cooperation with nurses in a private general hospital.In the 1996 academic year, we summarized the results of a study (from the 1995 academic year) on the actual conditions of patients with delirium in a private general hospital. We analyzed the primary factors in the appearance and disappearance of symptoms of delirium. We also conducted a questionnaire survey of 160 nurses on their perception of delirium and the care they are delivering. This survey showed that important factors in the care of patients with delirium include securing safety, communication, observation, stimulation and the rhythm of daily life. The results were presented at the 1^<st> Scientific Meeting of the Japan Academy of Gerontological Nursing (January, 1996).In the 1997 academic year, we examined the literature on the assessment of and care plans for delirium. We considered the content and structure of a care model based on our studies. We developed "a Proposal for a Care Model of Delirium"to clarify how to determine the pressence of delirium, and how to deal with and distinguish the causes of delirium. This proposal includes a delirium rating scale, information on causes, and guidelines for acute and preventive care.The model is intended as a guideline for nurses in a clinical setting for making decisions and taking action. In order to increase the content validity of the care model, we analyzed case studies in which the model was actually used, and obtained evaluations of the model from specialists and clinical nurses. We revised the model based on the above results and devised the "Care Model for Delirium".