The use of Functional Consequences Theory in acutely confused hospitalized elderly.

Acute confusion is a common complication of hospitalization in the elderly that impacts on both the use of health care resources and the functional status of individuals. Providing optimum nursing care for these patients depends on three factors: 1) the nurse's ability to differentiate acute confusion from other common conditions in the hospitalized elderly, chiefly dementia or depression, 2) the nurse's ability to identify factors contributing to this condition, and 3) the implementation of interventions to minimize the effects of these factors on the patient. This article differentiates the clinical features of acute confusion from those of depression and dementia, and discusses the use of the Functional Consequences Theory, developed by Miller (1990), as a framework for nursing assessment and management of care for elderly patients with this condition. The functional consequences theory framework assists the nurse to identify risk factors associated with the development of acute confusion in the hospitalized elderly. Further it guides the development of interventions to minimize the effects of this condition in this population. The use of this framework in the clinical setting is illustrated through a case study.