Family-administered delirium screening improves satisfaction among ICU caregivers: a prospective cohort study

PURPOSE: Family caregivers experience distress when their loved one is in the ICU, particularly in the setting of delirium. Limited English proficiency (LEP) may worsen this experience and contribute to long-term psychological burden. Yet, caregivers with LEP are rarely included in ICU research. Whether caregiver engagement using linguistically tailored delirium assessments improves satisfaction remains unknown. METHODS: We conducted a prospective cohort study in two academic ICUs evaluating delirium detection among English and Spanish-speaking ICU patients. Within this larger study, we performed a substudy of patient-caregiver dyads focused on caregiver satisfaction. Caregivers were assigned to: (1) FAM-CAM group, in which caregivers completed daily FAM-CAM delirium assessments, or (2) control group with no FAM-CAM exposure. All caregivers completed the Family Satisfaction in the ICU-24 (FS-ICU-24) after 3 days. Outcomes included overall satisfaction and subdomains of decision-making and care (0-100 scale). Independent t-tests compared satisfaction by language, FAM-CAM exposure, and patient delirium status. RESULTS: Among 120 dyads, 63 caregivers preferred English and 57 Spanish. English-speaking caregivers reported higher decision-making satisfaction than Spanish speakers (90.8 vs 85.6, p < 0.05). FAM-CAM exposure improved overall satisfaction across language groups (91.9 vs 84.4, p < 0.01). Patient delirium was linked to lower caregiver satisfaction, but FAM-CAM engagement mitigated this effect, with higher scores among exposed caregivers (90.9 vs 80.3, p < 0.05). CONCLUSIONS: English-speaking caregivers reported higher satisfaction scores than Spanish-speaking caregivers. Engagement with FAM-CAM improved satisfaction across language groups, highlighting its potential to enhance caregiver engagement and promote equity in the ICU.