Delirium

What is delirium?

Delirium is a term that is used to describe a state of acute confusion. It usually develops quickly over several hours or days. Delirium is a serious medical condition but usually gets better if treated.

How common is it?

A person of any age can have delirium. It is more common in older adults during a hospital stay. It is difficult to predict who will develop delirium. Several factors that increase the risk include:

  • Mental impairment
  • Vision problems
  • Severe illness
  • Infection
  • Dehydration

What are the symptoms?

Signs of delirium come on quickly. They can last for days or weeks, and sometimes longer. Symptoms can change hour to hour, but generally are worse at night. Common symptoms of delirium include:

  • Difficulty paying attention or concentrating. For example, the person may ask for things to be repeated again and again.
  • Confusion about time and place. The person may not know where he or she is.
  • Memory problems, especially of recent events. The person may not remember coming to the hospital, or the reason why he or she is there.
  • Agitation
  • Emotional changes, such as anxiety, sadness, or euphoria
  • Seeing, hearing, or feeling things that aren’t there
  • Confusing people or objects for something else

What causes delirium?

Delirium is not a specific disease, but it is usually caused by a treatable physical problem.

Possible causes of delirium:

  • Medication
  • Infection
  • Fluid and electrolyte disturbances
  • High or low blood sugar levels
  • Liver or kidney failure
  • Surgery
  • Cardiac problems

In many cases, there may be several possible causes.

How is delirium treated?

Treatment depends on what is causing the delirium. Many tests may help identify the cause. These tests include blood tests, x-rays, and specialized scans. Once the cause is identified, it can be treated. Managing the symptoms of delirium is also part of the treatment.

Treatment may include:

  • Stopping or changing medicines
  • Providing ways to help reorient the patient to the surroundings
  • Avoiding too much or too little stimulation
  • Offering continual reassurance and support

How can families help loved ones with delirium?

  • Visit often.
  • Gently talk to the patient about where he or she is and the date, time, or season.
  • Limit the number of people visiting at one time.
  • Provide a relaxed, comfortable environment.
  • Never argue with the patient or display frustration, as this may cause further stress.
  • Offer reassurance about care and safety.
  • Speak in a calm voice.

If You Think Someone Has Delirium

Delirium often occurs in a hospital, but the medical staff may not know that it is happening. They do not know what is normal for that person. Family and friend should tell a doctor or nurse if they notice a change in the person’s behavior.

If you think that someone who is not in the hospital has delirium, call the person’s doctor or take him or her to the emergency room as soon as possible.

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