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Article
Screening for acute confusion in elderly long-term care residents
Journal of Neuroscience Nursing
  • Kennith R. Culp, University of Iowa
  • Toni Tripp-Reimer, University of Iowa
  • K. Wadle
  • B. Wakefield
  • J. Akins
  • Paula Mobily, University of Iowa
  • M. Kundradt
Document Type
Article
Peer Reviewed
1
Publication Date
4-1-1997
NLM Title Abbreviation
J Neurosci Nurs
PubMed ID
9140844
DOI of Published Version
10.3928/19404921-20091103-02
Abstract
While acute confusion (AC) is frequently studied in the hospitalized elderly population, this phenomena has been largely ignored in elders who are residents in long-term care (LTC) facilities. The purpose of this study was to estimate the prevalence of AC in older LTC residents, the antecedent conditions present at the time of the AC event and the recognition rate of AC when assessed by staff nurses in two LTC facilities. This is a descriptive, longitudinal study with a 14 day follow-up period which incorporates a screening algorithm using AC instruments with established psychometric properties. A behavioral symptom instrument was also used in order to classify AC cases into clinical subtypes: hyperkinetic, hypokinetic and mixed. Staff nurses, using traditional assessment techniques and blinded to the case screening algorithm outcome, were asked to randomly evaluate both residents who were "clear" and those experiencing AC. Screening was conducted at both daytime and evening time-points. Of the 37 subjects followed, 15 (40.5%) screened positive for AC. Those AC cases with compromised cortical functioning indicative of Alzheimer's disease (n = 4) were particularly vulnerable to poor fluid intake. High risk medications (n = 7) and urinary tract infections (n = 7) were the most frequent antecedents. Most of the subjects experienced two or more antecedent conditions at the time of their AC. Staff nurses were able to identify 4 (26. 7%) of the 15 instrument-positive residents, none of which were of a hypokinetic clinical subtype. These early results suggest a high prevalence of AC among elders in LTC, which may go unrecognized by bedside care providers.
Keywords
  • Confusion -- Diagnosis -- In Old Age,
  • Confusion -- Epidemiology -- In Old Age,
  • Nursing Assessment,
  • Funding Source,
  • Nursing Home Patients,
  • Descriptive Research,
  • Prospective Studies,
  • Descriptive Statistics,
  • Research Instruments,
  • Risk Factors,
  • Veterans,
  • Confusion -- Etiology -- In Old Age,
  • Convenience Sample,
  • Long Term Care,
  • Diagnosis,
  • Laboratory,
  • Aged,
  • Male,
  • Female,
  • Human
Published Article/Book Citation
Journal of Neuroscience Nursing, 29:2 (1997) pp.86-. DOI:10.3928/19404921-20091103-02.
Disciplines
Citation Information
Journal of Neuroscience Nursing. 1997 Apr;29(2):86.