Evid Based Nurs 15:60-61 doi:10.1136/ebnurs-2011-100292
  • Care of the older person
  • Cross-sectional study

Delirium superimposed on dementia is pervasive and associated with restraint use among older adults residing in long-term care

  1. Donna Marie Fick
  1. School of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA
  1. Correspondence to Donna Marie Fick
    School of Nursing, The Pennsylvania State University, 201 HHDE, University Park, PA 16802, USA; dmf21{at}

Commentary on:

Implications for practice and research

  • Delirium is common in long-term care and was associated with physical restraint use in this study, which may worsen mental status and increase falls.

  • Nurses should carefully consider the trigger for behaviours that lead to the use of restraints (untreated delirium, pain or misinterpretation of stimuli) and attempt to manage these behaviours without chemical or physical restraints.

  • More research is needed to better measure environmental factors associated with delirium superimposed on dementia (DSD).


Delirium occurs frequently in older adults and leads to poor outcomes including increased death, higher costs and increased nursing care.1 2 Delirium is reversible, preventable and treatable when recognised early. Risk factors identified previously for delirium in acute …

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