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October 10, 2019

What You Need to Know About Delirium

 

“Delirium refers to a change in the brain’s neurochemistry that causes a person to become highly confused and unable to think clearly. People with delirium often can’t remember recent events or where they are. The condition usually comes on quickly, but the symptoms can come and go.” (NextAvenue.org)

On the one hand, as many as half of hospitalized older adults, aged 65 and up, develop this condition. On the other hand, delirium is no longer considered a normal part of aging, with medical professionals creating protocols with a focus on:

  • preventing delirium
  • detecting the condition when it’s happening
  • treating delirium

If the condition is detected, doctors typically seek out the underlying cause, whether that’s a urinary infection, a heart issue, pneumonia or an adverse reaction to a medicine, as just a few examples. Treatment then focuses on dealing with the underlying cause of this person’s mental disorder, while also making sure the person gets enough fluids, proper nutrition and enough rest.

Medical professionals often encourage friends and family members to talk to the person suffering from delirium to reorient them. Sometimes, sharing family photos can help or talking about favorite memories. In certain cases, a doctor might prescribe medication, but that can be a risky strategy because antipsychotic drugs can actually add to the patient’s confusion.

Delirium Versus Dementia

Delirium can mimic types of dementia, such as Alzheimer’s disease. If there is a rapid onset, then it’s more likely to be delirium, with dementia typically developing more gradually. In the early stages of Alzheimer’s disease, the person can often still remain relatively alert and attentive; with delirium, their focus is usually significantly impaired, even in early stages. Plus, delirium can come and go, fluctuating throughout the day. Although people with dementia can have better and worse days, fluctuations in mental function don’t typically happen as quickly.

Note: It’s possible that someone is experiencing both conditions.

Post-Op Risk Factors

Someone is more likely to develop delirium after an operation if he or she:

  • Is an older adult
  • Has a physical disability
  • Has dementia
  • Abuses alcohol
  • Had hip or heart surgery
  • Has “abnormal blood tests”

Additional Risk Factors

Some of the most treatable forms occur as a side effect of medicine or when a medication is suddenly stopped. If you suspect that a loved one is suffering from delirium, share known information about prescription and nonprescription drugs that the person was taking with medical professionals — including if any were recently stopped. Overusing or suddenly stopping alcohol use can have the same effect, so share that information, as well.

Sensory deprivation can serve as a trigger, perhaps in someone who stays in a room in a nursing home for a length of time. Rooms without windows may have more of an impact. If someone has vision and/or hearing loss, that can also be a risk factor.

Medical Emergency Situations

Sometimes, symptoms of delirium happen before someone has a heart attack. This condition can also occur because of a stroke, brain infection or brain tumor, but that’s less common. Delirium can occur alongside an intestinal blockage, liver or kidney failure and more. This condition can also develop as a result of poisoning. Find more information about delirium at MedlinePlus.gov.

Seeking Medical Help

If someone is becoming increasingly more confused or is exhibiting significant changes in behavior and/or mental status, contact the person’s doctor. If it seems as though your loved one needs immediate attention, call 911. If the person is already in the hospital, notify the nurse so that the situation can be checked by medical professionals.

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