What is delirium?
It is confusion that comes on quickly over a matter of hours. It may affect one’s thinking, attention, and behavior. Often it will get better, but sometimes it does not. It is not the same as dementia.
What are risk factors for delirium?
A person has a higher chance of delirium if they:
- Are very sick
- Are an older age
- Have memory loss
- Are dehydrated (not having enough water in the body)
- Have inadequate pain control
- Are constipated
- Cannot urinate (pee) or pee small amounts
- Have a brain disease or damage
- Take certain medicines
What signs of delirium might a person have?
- Trouble paying attention
- 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”)
- Lack of energy, (slowed speech 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 for families: Signs may change throughout the day. Your loved one may seem like their normal self at times.
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?
- Do they use medicine as needed, for pain, anxiety, to pee, or to sleep at home?
- Has there been a change in eating or drinking?
- Is there a new cough or problem swallowing?
- Did the patient just stop drinking alcohol?
- Did they just stop using non-prescribed medicines or drugs?
- Any signs of delirium you have noticed (see signs of delirium above)
- Health problems your loved one has
How do you prevent delirium?
Help keep your loved one thinking clearly:
- Arrange for friends and family to visit. Keep visitors to 1 or 2 people at a time.
- Promote activity during the day and sleep routines at night.
- Use a calm voice. Keep sentences short and simple.
- 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. Ask for a Patient's Library packet.
- Bring in a clock, calendar, and pictures from home. Write the date on the whiteboard.
Support healthy nutrition, sleep, and physical activity
- Help your loved on order meals. You can help them eat and drink but ask their care team first.
- If they can, eat meals while sitting in a chair.
- Lower noise and distractions. Ear plugs and eye masks are available.
- Let in sunlight during the day. Keep the room dark at night.
- Ask about the Relaxation Channel, white noise machines, and weighted blankets.
- Help them sit in a chair, walk, and move around, if it is safe. Please ask their care team first.
- Ask your care team about games and activities.
Support good hearing and seeing
- Make sure hearing aids are working and are in place. Ask about a Pocket Talker.
- Talk slowly and in a deeper tone of voice in the better ear.
- If they uses glasses, make sure they are wearing them. Ask about reading glasses in needed.
How do you treat delirium?
Treatment involved fixing the medical issues that cause the delirium and treating troubling symptoms. Each person is different. It might go away quickly, last for weeks, or never go away. Let the care team know if you think you loved one has delirium.