Spotting the signs
There are different signs you can look for which may help to answer the question, “Have they been more confused lately?”
Disorientation or alertness: A person with delirium is often disoriented with regards to:
- The date.
- The month.
- The year.
- The time of day.
They may be confused about where they are and who any other person is. Sudden reduced concentration and alertness can occur. Their family or carers may find them to be overactive (hyper) or quite lethargic (hypo) or difficult to wake up.
Behaviour or thinking: Changes to behaviour or the way the person communicates is common.
The family may find it more difficult to follow the person’s conversation. When they talk they can be easily distracted and change topic a number of times. Disorganised thinking and a sense of being misunderstood can make the person feel frustrated and act in an aggressive way.
Hallucinations: The person may suddenly start having hallucinations (seeing or hearing things that are not there) or talking about strange experiences. Their hallucinations and thoughts can be very frightening, and the person may act to escape them.
Delusions: The person might become suspicious. They may think they are being watched (because of that, they may get frightened of any interaction with others) or they might think that food and drinks are being poisoned.
People who have had delirium say they:
- Felt unsure of their whereabouts.
- Worried that other people were trying to harm them.
- Felt afraid, irritable, anxious or depressed.
- Felt slow and sleepy.
- Felt agitated and restless.
- Had vivid dreams that continued when they woke up.
- Found it hard to follow what is being said.
- Found it difficult to speak clearly.
- Saw and heard things that were not there.
Video
Watch the video below from Dr Mani Krishnan, hashtag ‘icanpreventDELIRIUM’ for more information.
If you are unable to watch the embedded video, click the following link – What is delirium? (Vimeo)
Stopping delirium
The treating doctor needs to identify and treat the underlying cause of delirium, whether it is pain, constipation or any other cause by ensuring the person stays well hydrated, has good hand hygiene and follows any advice they’re given about wound care and medical devices (such as catheters).
The doctor may request blood and urine tests and will be able to decide on appropriate treatment. They may also want to review any medication that could be contributing to the delirium.
There is no specific medical treatment for delirium itself, but there are ways to manage the symptoms linked to it.
How long does delirium last?
Symptoms usually get better over a few weeks. But sometimes, even when the underlying cause of the delirium has been treated, symptoms can last for up to 6 months.
Most people recover completely from an episode of delirium. However, some people may experience lasting problems.
Sometimes people can remember their experience of delirium.
This may include frightening and upsetting memories. Reassurance and explanation can help support the person and their family.
Delirium can worsen people’s mental function.
They may need more support with their day to day lives and some people may need 24 hour residential care.
Having delirium increases risk of death in the following year.
Delirium is associated with poorer health and an increase in care needs.
After one episode, physical illness may cause delirium to return.
It is important that, if you think delirium is returning, to act fast and seek treatment for the physical illness trigger. This may prevent the delirium becoming worse.