Terminal delirium misdiagnosed as major psychiatric disorder: Palliative care in a psychiatric inpatient unit

Palliat Support Care. 2016 Jun;14(3):307-10. doi: 10.1017/S147895151500098X. Epub 2015 Oct 22.

Abstract

Background: Delirium is a neuropsychiatric condition characterized by acute change in cognition and disturbance of consciousness. A similar state during the final days of life is termed "terminal delirium."

Method: We present three cases with end-stage chronic medical problems without any significant psychiatric history who were admitted to an inpatient psychiatric unit or a locked dementia unit for management of "depression," "dementia," or "psychosis."

Conclusions: Early diagnosis of terminal delirium helps prevent patients, family members, and staff from undergoing severe emotional distress and facilitates appropriate end-of-life care.

Keywords: Delirium; Dementia; Depression; End-of-life care; Terminal delirium.

MeSH terms

  • Aged
  • Critical Illness / psychology*
  • Delirium / complications
  • Delirium / diagnosis*
  • Female
  • Humans
  • Inpatients / psychology
  • Male
  • Mental Disorders / diagnosis
  • Middle Aged
  • Palliative Care / methods*