Critically ill patients nearing the end of life are frequently challenged by issues
centered around delirium and sedation. Most often these issues arise in the context
of changing goals of therapy from cure to comfort, after some attempts at reversing
progressive illness have not been successful, and clinicians, families, and possibly
patients are coming to terms with this reality. In this setting delirium is common,
often with multifactorial etiologies. Clinicians often struggle to ensure comfort
to dying patients while permitting communication between patients and loved ones or
caregivers. The common experience of pain in these patients and need to provide adequate
analgesia further confounds the desire to facilitate communication for dying patients.
This article will discuss delirium and sedation as it applies to dying patients, review
available literature in this area, and provide recommendations for effective management
strategies.
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Article info
Footnotes
☆Supported by the National Institute of Health (NIH)/National Institute of General Medical Sciences (NIGMS) grant K23 GM63906.
☆No financial disclosures to report for either author.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
