Special Section: Studies to Understand Delirium In Palliative Settings (SUNDIPS) Treating an Established Episode of Delirium in Palliative Care: Expert Opinion and Review of the Current Evidence Base With Recommendations for Future Development Shirley H. Bush, MBBS, MRCGP, FAChPM, Salmaan Kanji, BSc Pharm, PharmD, Jos e L. Pereira, MBChB, CCFP, MSc, Daniel H.J. Davis, MBChB, MRCP, David C. Currow, BMed, MPH, FRACP, David J. Meagher, MD, PhD, MRCPsych, Kiran Rabheru, MD, CCFP, FRCP, DABPN, David Kenneth Wright, RN, PhD, CHPCN(C), Eduardo Bruera, MD, Meera Agar, MBBS, FRACP, Michael Hartwick, MD, FRCPC, Pierre R. Gagnon, MD, FRCPC, Bruno Gagnon, MD, MSc, William Breitbart, MD, FAPM, FAPA, Laura Regnier, BSc, MSc, MD, CCFP, and Peter G. Lawlor, MB, FRCPI, MMedSc Division of Palliative Care (S.H.B., J.L.P., M.H., P.G.L.) and Division of Critical Care (M.H.), Department of Medicine; Department of Psychiatry (K.R.); Department of Family Medicine (L.R.); Department of Epidemiology and Community Medicine (P.G.L.), University of Ottawa; Bruy  ere Research Institute (S.H.B., J.L.P., P.G.L.), Bruy  ere Continuing Care; The Ottawa Hospital Research Institute (S.K., P.G.L.); Department of Pharmacy (S.K.) and Department of Radiation Oncology (L.R.); The Ottawa Hospital (K.R., M.H.), Ottawa, Ontario, Canada; Institute of Public Health (D.H.J.D.), University of Cambridge, Cambridge, United Kingdom; Discipline, Palliative & Supportive Services (D.C.C., M.A.), Flinders University, Adelaide, South Australia, Australia; Graduate Entry Medical School (D.J.M.), University of Limerick, Limerick, Ireland; McGill University (D.K.W.), Montreal, Qu ebec, Canada; Department of Palliative Care and Rehabilitation Medicine (E.B.), The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; South West Sydney Clinical School (M.A.), University of New South Wales; Department of Palliative Care (M.A.), Braeside Hospital, HammondCare, Sydney, New South Wales, Australia; Faculty of Pharmacy et Centre de Recherche en Canc erologie (P.R.G.) and D epartement de M edecine Familiale et de M edecine d’Urgence (B.G.), Universit  e Laval; Department of Psychiatry (P.R.G.), CHU de Qu ebec; Centre de Recherche du CHU de Qu ebec (B.G.), Qu ebec City, Qu ebec, Canada; and Department of Psychiatry and Behavioral Sciences (W.B.), MemorialSloan-Kettering Cancer Center, New York, New York, USA Abstract Context. Delirium is a highly prevalent complication in patients in palliative care settings, especially in the end-of-life context. Objectives. To review the current evidence base for treating episodes of delirium in palliative care settings and propose a framework for future development. Drs. Bush and Kanji contributed equally to this article. Address correspondence to: Shirley H. Bush, MBBS, MRCGP, FAChPM, Bruy ere Continuing Care, 43 Bruy ere Street, Ottawa, Ontario K1N 5C8, Canada. E-mail: sbush@bruyere.org Accepted for publication: July 31, 2013. Ó 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved. 0885-3924/$ - see front matter http://dx.doi.org/10.1016/j.jpainsymman.2013.07.018 Vol. 48 No. 2 August 2014 Journal of Pain and Symptom Management 231