Background

Delirium:

Delirium adversely affects function and outcomes and is associated with high morbidity and mortality. It is an acute, complex disorder that requires immediate interventions to prevent permanent brain damage and health risks, including death. It is “associated with mortality rates of 25-33 %, and results in increased length of hospital stay, increased intensity of nursing care, more institutional placements, and greater healthcare costs” (Inouye, 2000, p. 257).

Dementia:

The key features of dementia include multiple cognitive deficits which are severe enough to cause impairment in an individual’s social or occupational functioning, and represent a decline from a previous level of functioning (APA, 1997). These cognitive deficits include memory impairment and at least one of the following: aphasia, apraxia, agnosia, or a decline in executive functioning. The prevalence of dementia increases with age and ranges from a low of 8 % for individuals aged 65 years to 35 % for those aged 85 years and older (Canadian Study of Health and Aging Working Group, 1994).

Depression

Depression is a multi-faceted syndrome, comprised of a constellation of affective, cognitive, somatic and physiological manifestations, in varying degrees from mild to severe (Kurlowicz & NICHE Faculty, 1997; National Advisory Committee on Health and Disability, 1996; National Institute of Health Consensus Development Panel, 1992). Depressive symptoms occur in 10 to 15 % of community-based elderly requiring clinical attention. Mortality and morbidity rates increase in the elderly experiencing depression, and there is a high incidence of co-morbidity with medical conditions (Conwell, 1994).

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