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 of patient-caregiver dyads in two academic ICUs. 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 and mitigated the negative impact of delirium, supporting its potential to enhance caregiver engagement and promote equity in the ICU.