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Clinical Profile of Acute Confusion in the Long-Term Care Setting

St. Louis University School of Nursing

Kennith Culp

University of Iowa College of Nursing

Joan Laing

University of Iowa College of Nursing

Toni Tripp-Reimer

University of Iowa College of Nursing

Aspects of acute confusion (AC) including risk factors, behavior patterns, and outcomes are not well documented in long-term care (LTC) residents. The purpose of this prospective study was to describe the clinical profile of AC in LTC including risk factors, behavior patterns, etiologies, and 3-month outcomes. Seventy-four elderly LTC residents were assessed for AC, depression, and global cognitive impairment. Risk factors associated with AC included hearing deficits, depression, pulmonary disorders, and abnormal serum sodium or potassium levels. Behavior patterns of acutely confused residents included hyperactive (n = 9, 31%), hypoactive (n = 8, 28%), and mixed (n = 7, 24%). In the majority of the AC cases, the etiology was multifactorial: Infections and dehydration were the most common causes. Residents with AC had very poor 3-month outcomes. Thirty-four percent (n = 10) of the residents with AC died within 3 months of the evaluation. This study highlights the complexity and serious nature of AC in this frail population.

Key Words: delirium • acute confusion • long-term care • outcomes

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