Pragmatic Strategies for Delirium Screening and Management in Older Long-term Care Facility Residents: A Comprehensive Review

Background Delirium prevalence is as high as 70% in long-term care (LTC) and is related to adverse outcomes. However, little research has been carried out to support clinicians in the adequate management of this geriatric syndrome. The purpose of this paper is to provide a comprehensive general review on delirium screening and management in LTC. Methods A literature search was performed for each topic within the guidelines, prioritising recently published systematic reviews and Cochrane reviews, with primary data searching when no or limited reviews were available. Results We discuss the implication for the evaluation of a new resident at the time of LTC admission, using a comprehensive geriatric assessment. We then describe indications for delirium screening and criteria for diagnosis. Although there are significant limitations in the existing literature, we summarize the knowledge on non-pharmacological and pharmacological interventions for delirium prevention and management. Finally, information is provided for staff education, and involvement of family members and volunteers. Conclusion There is limited evidence of the epidemiology of delirium in LTC and the effectiveness of programs for delirium prevention and treatment. Recent guidelines advocate for a cohort study in people residing in the LTC facilities to address the current gap in the literature and to improve the care of persons living in LTC.