Delirium is a sudden loss of attention, disorientation, a lack of awareness, and an inability to think clearly. Delirium may develop in a matter of hours or over several days. Symptoms may be severe and they may come and go.
What is the cause?
Delirium is a symptom of another problem. It may be caused by something that changes chemicals in the brain or changes the way the brain uses oxygen. It may be caused by medicine you are taking or by a medical problem.
Delirium caused by medicines can be a particular problem for older adults, who may be taking several different drugs. Also, as you get older, your body may not process drugs well. As a result, drugs can stay too long in the body and cause more side effects.
Examples of medical problems that can lead to delirium include:
Infection in the lungs, bladder, or kidneys
A physical change in the brain, which can happen, for example, from a stroke or tumor
Not getting enough sleep
Alcohol use and withdrawal from alcohol can cause delirium.
If you are in the hospital for several days or are very ill, you have a greater risk for delirium. This is especially true if you are in the critical care unit or intensive care unit (ICU). You may not be able to sleep, and there may be no windows and no day and night routines to help keep you oriented.
What are the symptoms?
The key symptoms are confusion and disorientation. Disorientation means not knowing the time, date, where you are, or who you are. Other symptoms may include:
Being restless or agitated
Not being able to concentrate or pay attention
Not being able to remember things
Trouble following directions
Sleep problems, including not being able to sleep at night and being sleepy during the day
Seeing or hearing things that are not there
If you are panicked, upset, and agitated but you know who you are, where you are, and what is going on around you, you do not have delirium.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history, including medicines you are taking. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to check for possible causes of the symptoms.
Your provider may also ask some questions to test memory and thinking and to check for depression. Key questions to test for confusion are:
Do you know where you are, the date, and the time?
Do you know why you are here?
Can you describe current events in the news or in your own life?
Your provider may check with family, friends, and hospital staff to see if things said by you are true or imagined.
If someone has new or worse symptoms of delirium, seek medical help. Donâ€™t leave a delirious person alone.
How is it treated?
Treatment depends on what is causing the delirium. For example, changing medicines or treating a medical problem may take care of the problem.
Treatment may also include:
Keeping you safe from harm, which may mean sitting with you at all times, or in rare cases using restraints
Help with personal care and meals for a time
Calm and quiet surroundings
Support from family, friends, and healthcare providers to help orient and calm you
Glasses or hearing aids if you have poor hearing or eyesight
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-01-29 Last reviewed: 2014-01-12
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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Goldman: Goldman’s Cecil Medicine, 24th ed.; Chapter 27 – Delirium or Acute Mental Status Change in the Older Patient >> Delirium. Accessed 9/19/2011 via http://www.MDConsult.com.