What is delirium?

Submitted by Emma Hamilton on Fri, 17/10/2008 - 2:47pm

Delirium is a serious medical condition causing acute confusion.

People with delirium experience changes in cognition such as disorientation, agitation and delusions. Unlike dementia, symptoms of delirium occur suddenly.

People with delirium can be drowsy, irritable or appear different to their normal selves. Insomnia and night-time disturbance are also common symptoms of delirium. A person with delirium can appear frightened, angry or have difficulty paying attention.

Symptoms can often fluctuate during the day. It can last a few days or weeks and if left untreated can lead to serious medical complications.

What causes delirium?

Delirium can have many causes. Older people can be more susceptible to delirium due to multiple physical illnesses, over the counter drugs, and even stressful situations. Many older people experience delirium after surgery or during a hospital stay.

Delirium can be caused by:

Infection
Pain
Medications
Electrolyte disturbance
Surgery
Withdrawal from alcohol
Dehydration

Delirium can also co-exist with dementia and be difficult to tell apart. Unfortunately sudden changes in behaviour or confusion can be overlooked in people with dementia and mistaken for a natural progression of dementia.

As a carer you will be a valuable resource for your doctor as changes may be subtle and confounded by dementia.

A simple urinary tract infection (UTI) can cause delirium along with chest infections, head injury and changes in blood glucose levels.

Treating delirium

If the person you care for shows any sudden changes in mood, memory or orientation see your doctor immediately. Treatment of delirium will depend on the underlying cause.

A doctor may order a number of blood or urine tests, look at any medications a person is taking or take a mental status assessment. Assessment of delirium could also involve other investigations including xrays and brain scans.

Caring for someone with delirium

If you are caring for someone with delirium they will need extra support and care. Pay particular attention to the environment. Try and keep the person in a familiar environment by avoiding moving a person too much.

It can be comforting for people experiencing delirium to see familiar faces and friends especially if the person is in hospital.

If a family member is in hospital with delirium it may help to organise extra care such as hiring a nurse for an overnight stay. Older people with delirium are more at risk of falls and will need special monitoring. It can help to remove objects from the bed side if the person is agitated and use soft night lights for orientation.

Things you can try:

Talk clearly and slowly.
Ensure the person gets adequate food and fluids.
Orientate the person to their environment. Remind them where they are, what time of day it is and who you are.
Diminish distracting loud noises such as radio and television.
Ensure a person has their comfort items such as familiar blankets, photos and favourite music or clothing.
Check the person is wearing hearing aids and glasses.
Protect the person from falls and dangerous objects.
Do not restrain a person.
Try placing a mattress on the floor for night time waking.
Discourage day time sleeping.