Delirium

What is delirium?

It is confusion that comes on quickly over a matter of hours. It may affect one’s thinking, attention, and behavior. It is a serious problem that will often get better. Sometimes it does not get better. People with delirium are not crazy, and it is not the same as dementia.

What signs of delirium might a person have?

• Trouble paying attention or concentrating
• Not knowing who or where they are
• A change in behavior, such as:
  • Agitation (hitting or pushing, resisting care, or not cooperating)
  • Restlessness (feeling a need to move around or feeling tense and “stirred up”)
  • Lethargy (lack of energy), slowed speech and/or movements
  • Change in sleep (may be more awake at night and asleep during the day)
  • Any other change in behavior or personality that is not normal
• A change in perception, such as:
  • Seeing or hearing things that others do not
  • Paranoid beliefs (thinking people are trying to hurt them) and not feeling safe
• A change in mood, such as:
  • Anxiety (being very nervous and fearful)
  • Depression (feeling sad or upset)
  • Anger
• Thoughts or words not making sense
• Mumbling or slurred speech

Note: Symptoms may change throughout the day. Your loved one may seem like their normal self at times.

What are risk factors for delirium?

A person has a higher chance that delirium will happen if they:

• Are very sick
• Older age
• Have dementia
• Are dehydrated (not having enough water in the body)
• Are constipated (trouble pooping)
• Cannot urinate (pee) or urinating small amounts
• Have prior brain disease or damage
• Take certain medicines

How do you treat delirium?

Treatment involves fixing the medical issues that are causing the delirium and treating any troubling symptoms. Each person is different. Delirium might go away quickly or last for weeks. It might never go away. Let the care team know if you think your loved one has delirium.

Tell the care team:

• When you first saw a change in how your loved one acted or thought
• If something changed just before this new action or thinking started.
  • Was a medicine added or taken away?
  • Has there been a change in eating or drinking?
  • Is there a new cough or problem swallowing?
  • Did the patient just stop drinking alcohol?
  • Were any treatments recently stopped or started?
  • Was there a recent surgery or stay in the hospital?
• Any signs of delirium you have noticed
• Health problems your loved one has 
• What medicines does your loved one take?
  • Do they use a medicine as needed, for pain, anxiety, or sleep?
  • How many doses have been taken?

Help keep your loved one thinking clearly:

• Arrange for friends and family to visit. Keep visitors to one or two people at a time.
• Keep sentences short and simple.
• Use a calm voice.
• Gently remind them where they are and what is going on.
• Talk about current events and what is going on nearby.
• Talk about childhood memories or favorite music.
• Read out loud or using large print books.
• Bring in a clock, calendar, and pictures from home. Write the date on the whiteboard.
• Avoid trying to correct false beliefs, perceptions, and unusual behaviors.

Support healthy rest, sleep, and physical activity

• Decrease noise and distractions.
• Let in sunlight during the day. Keep the room dark at night.
• Keep lights low or off when they are resting.
• Help them sit in a chair, walk, and move around, if it is safe. Please ask the health-care team first.

Support healthy eating and drinking

• If swallowing is not a problem and your loved one is hungry or thirsty, help them eat and drink. Please ask the health-care team first.

Support good hearing and seeing

• Make sure hearing aids are working and are in place.
• Talk slowly and in a deeper tone of voice in the better ear.
• If they uses glasses, remind your loved one to wear them.
• Use good lighting.