Terminal delirium misdiagnosed as major psychiatric disorder: Palliative care in a psychiatric inpatient unit

Background: Delirium is a neuropsychiatric condition characterized by acute change in cognition and disturbance of consciousness. A similar state during the final days of life is termed terminal delirium. Method: We present three cases with end-stage chronic medical problems without any significant psychiatric history who were admitted to an inpatient psychiatric unit or a locked dementia unit for management of depression, dementia, or psychosis. Conclusions: Early diagnosis of terminal delirium helps prevent patients, family members, and staff from undergoing severe emotional distress and facilitates appropriate end-of-life care.