Experiences of Caregivers of Older Persons with Delirium Superimposed on Dementia in Acute Care Hospitals: An Interpretive Description Study

Abstract

Background: Delirium superimposed on dementia (DSD) is a highly prevalent, yet difficult to recognize problem in hospitals. Delirium is a disturbance in cognition often seen in persons aged 65 and older. DSD occurs when a person living with dementia (PLWD) also develops delirium. DSD is a highly distressing experience for caregivers. Aims: This study aims to explore the experiences of caregivers of older persons with DSD in acute care hospitals; their role in the detection and management of DSD; and the type of support they require during this experience. The knowledge generated from this study can be used to identify strategies to assist caregivers during their experience, and to improve the early detection and management of DSD, with the aim to improve health outcomes for both the hospitalized older person with DSD and the caregiver. Methods: Thorne’s interpretive description method was used. In-person, semi-structured interviews were conducted with nine caregivers of older persons with DSD who were hospitalized in four medicine units. Interviews were transcribed and thematic analysis was conducted. Results: The following themes related to caregivers’ experiences were identified: (a) caregivers found DSD to be an overwhelming experience, (b) caregivers were concerned about the quality of care that the older person received, (c) caregivers’ experiences were influenced by the nature of their relationship with the health care team, and (d) caregivers can play an important role in the detection and management of DSD. Conclusion: Findings provide guidance in increasing support and building collaborative relationships between caregivers and the health care team. Recommendations on delivering caregiver-centred care to caregivers of older persons with DSD are outlined.