South Korean Nurses’ Cognitive Impairment Care in Hospitalised Older Adults

Abstract

In South Korea, the prevalence of dementia is rapidly increasing alongside the ageing of the population. The prevalence of dementia among South Korean older adults (age ≥ 65 years) was 8.4% (n = 421,387) in 2008, and it is expected to increase to 9.7% (n = 741,719) by 2020 and to 13.2% (n = 2,217,419) by 2050 (Cho, Kim, et al., 2008). The inpatient hospital costs for Alzheimer‘s disease, the most common form of dementia, are reported as being greater than for any other disease in South Korea (Korea Health Insurance Review and Assessment Service, 2015). In the first half of 2015, the inpatient hospital spending for Alzheimer‘s disease in South Korea was US$388,555,222 in total and US$6,548 per person (Korea Health Insurance Review and Assessment Service, 2015). The rapid increase in the population of people with dementia has the potential to increase the likelihood of health care professionals in hospitals in South Korea encountering older adults with delirium or delirium superimposed on dementia (DSD) in their daily practice. Delirium is defined as an acute impairment in cognition and a disturbance in awareness and attention (American Psychiatric Association, 2013). Delirium is four times more likely to occur in hospitalised older adults with dementia compared with hospitalised older adults without dementia (Franco et al., 2010), and is distressing for patients, families and health care professionals (Breitbart, Gibson, & Tremblay, 2002; Bruera et al., 2009; Toye, Matthews, Hill, & Maher, 2014). Delirium is also linked to a range of serious adverse outcomes such as increased morbidity, mortality, and health service utilisation (Bellelli et al., 2007; Fick, Agostini, & Inouye, 2002; Fick, Steis, Waller, & Inouye, 2013; Morandi et al., 2014; Sampson, Blanchard, Jones, Tookman, & King, 2009; Torpilliesi, Bellelli, & Trabucchi, 2010).