Challenges for the family physician in managing delirium in patients with palliative care needs

Delirium is an acute mental state characterized by con­fu­sion and disorientation, frequently observed in elderly pa­tients, especially in palliative care. The etiology of de­li­rium is multifactorial, including metabolic imbalances, ad­verse drug effects, infections and organ failure. The pre­do­mi­nant symptoms are attention deficits, memory and sleep disturbances, hallucinations and affective changes. De­li­rium increases mortality and presents challenges for care­givers and family physicians involved in the home care of terminal patients. The diagnosis is made using the Con­fu­sion Assessment Method (CAM), which evaluates cog­ni­tive dis­tur­bances. The treatment involves identifying and ad­dres­sing the underlying cause and using haloperidol as the first-line the­ra­peu­tic option, sometimes in combination with ben­zo­dia­ze­pines in specific cases. Preventive strategies, such as avoiding unnecessary hospitalizations, correcting hydro­elec­tro­ly­tic imbalances and maintaining a familiar en­viron­ment, are recommended, reducing the risk of delirium by ap­pro­xi­mately 30%. Effective management requires clear pro­to­cols and prompt intervention in palliative care.