Study of Caregiver Burden in Delirium

Objectives: Objectives of this study are to study the aetiology of patients of delirium in old age, to study the severity of delirium in old age, to study the burden of family care givers in delirium patients and to study the relationship between severity, aetiology of delirium with the burden severity in family caregivers. Design: Prospective, observational, and cross sectional. Setting: Inpatient tertiary care hospital setting. Participants: Subjects with the diagnosis of Delirium qualifying according to ICD-10 (international classification of disease-10) and confirmed with CAM scale aged >60 years and Patient or patient’s family members willing to give consent. Measurements: Sociodemographic questionnaire, Confusion assessment method, Delirium index, Delirium aetiology check list, ICD -10 DCR, Care giver burden scale and The Barthel index are the instruments used. Results: 62.5 percent of the subjects are males.37.5 percent subjects are females.42.5 percent of the caregivers are male, and 57.5 percent of caregivers are females.27.5 percent of the care givers are spouses,35 percent parents,15 percent children,10 percent siblings,12.5 percent others. 30 percent of the subjects are single,42.4 percent are married,27.5% widow.57.5 percent of the subjects are hindu,42.5 percent muslims.17.57 percent of subjects are illiterate,27.5 percent are up to 5 th ,35 percent are up to 10 th,20 percent are up to 12^th standard.12.5 percent subjects are unemployed,30 percent are unskilled/semiskilled,25 percent are skilled,17.5 percent are professionals,7.5 percent are housewifes,7.5 percent are retired.42.5 percent are urban residents,57.5 percent are rural residents.37.5 percent have duration of delirium less than 1 week,45 percent have duration of delirium 2-4 weeks,17.5 percent have duration of delirium more than 1 month.25 percent subjects have family history of delirium,75 percent have no family history of delirium.95 percent developed delirium while on medical treatment,5 percent developed delirium after surgical treatment.32.5 percent have no substance use,22.5 percent have tobacco use,10 percent have alcohol use,35 percent have multiple substance use.85 percent subjects have a precipitating factor and 15 percent have no precipitating factor for the development of delirium.17.5 percent have diabetes mellitus,17.5 percent have systemic hypertension,5 percent have tuberculosis,10 percent have other medical co morbidities,50 percent have multiple co morbidities. There is no significant association between gender of the subject and care giver burden. There is no significant association between caregiver relation and care giver burden. There is no significant association between duration of delirium and care giver burden. There is significant difference between care giver burden and delirium aetiology checklist. Moderate to severe and severe burden are maximum in subjects with multiple co morbidities and infection. There is no significant association between Barthel index and care giver burden. There is no significant association between delirium index/severity of delirium and care giver burden. Conclusions: In this study results showed that there is significant association between delirium is an acute illness with sudden onset with maximum percentage of duration 2-4 weeks, delirium is more in males than females, majority of the care givers are spouses and parents, multiple aetiologies, diminished psychological QoL are associated with increased care giver burden. Family history of delirium is associated with better care giver burden. Employed subjects with delirium have better overall QoL.As duration of delirium increases, delirium severity increases.