The Challenges That Arise in Decision-Making When Delirium Sets In

Delirium is highly prevalent and often under-diagnosed geriatric syndrome in the hospital setting. Typically an acute confusional state related to an underlying cause(s), delirium is manifested by change in one’s mental status compared to baseline, inattention, bizarre behavior, and altered level of consciousness. Delirium could become chronic and terminal over time, especially in the context of a serious illness.

This Master Clinician session will highlight the challenges in assessing decision-making capacity for a patient with delirium, including when a health care proxy’s decision is not aligned with the patient’s goals. The case presented will also illustrate ways in which support can be provided to family members and clinicians struggling both morally and ethically when caring for a dying patient.