Editor's Correspondence |

Delirium and Costs of Informal Home Care

Giuseppe Bellelli, MD; Angelo Bianchetti, MD; Marco Trabucchi, MD
Arch Intern Med. 2008;168(15):1717. doi:10.1001/archinte.168.15.1717-a.
Text Size: A A A
Published online


We read with great interest the article by Leslie et al1 on the costs associated with delirium. We would like to contribute to the topic with our own data, confirming the high burden of delirium in elderly patient care. We recently observed that delirium is a determinant of hospital readmission and institutionalization after discharge from a rehabilitation unit.2 Furthermore, we demonstrated that patients with delirium during hospital admission have a lower functional level 1 year later compared with controls.3 These data are by themselves indirect indicators of higher costs (increased use of hospital and nursing homes). However, what is most important is the rate of functional impairment induced by delirium because delirious patients, once returning home, require a higher level of care in basic and instrumental activities of daily living. In Italy, the role of caregiving for elderly patients is usually committed to persons who are paid by their families because in our country the formal home-care system is rather poor and confined to a few areas of intervention. These persons, mostly women from eastern European countries, live with the elderly for 6 to 7 days a week, 24 hours daily. At present, we estimate that this workforce comprises approximately 900 000 persons, each one receiving approximately €1000 monthly. These costs are not reimbursed by the national health care system and burden families.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles

The Rational Clinical Examination
Make the Diagnosis: Delirium

The Rational Clinical Examination
Original Article: Does This Patient Have Delirium? Value of Bedside Instruments