Delirium can last for a few days, weeks or even months but it may take longer for people with dementia to recover. In hospitals, approximately 20-30% of older people on medical wards will have delirium and up to 50% of people with dementia . Between 10-50% of people having surgery can develop delirium.
Preventive interventions such as frequent reorientation, early and recurrent mobilization, pain management, adequate nutrition and hydration, reducing sensory impairments, and ensuring proper sleep patterns have all been shown to reduce the incidence of delirium , regardless of the care environment.
Delirium is most often caused by physical or mental illness and is usually temporary and reversible . Many disorders cause delirium .
The person may become confused, or be more confused than usual. Or they may become sleepy and drowsy. Delirium can be distressing to the person and those around them, especially when they don’t know what’s causing these changes.
Treatment for delirium depends on the cause. Treatments may include: Antibiotics for infections. Fluids and electrolytes for dehydration. Antipsychotic drugs include: Haloperidol (Haldol®). Risperidone (Risperdal®). Olanzapine (Zyprexa®). Quetiapine (Seroquel®).
Patients at the end of life develop a number of distressing symptoms . Although delirium is one of the most common neuropsychiatric problems in patients with advanced cancer, it is poorly recognised and poorly treated. Delirium is prevalent at the end of life , particularly during the final 24–48 h.
In the long term, delirium can cause permanent damage to cognitive ability and is associated with an increase in long-term care admissions. It also leads to complications, such as pneumonia or blood clots that weaken patients and increase the chances that they will die within a year.
Probably the most easily recognized type, this may include restlessness (for example, pacing), agitation , rapid mood changes or hallucinations , and refusal to cooperate with care. Hypoactive delirium. This may include inactivity or reduced motor activity, sluggishness, abnormal drowsiness, or seeming to be in a daze.
Some of the most common causes of sudden confusion include: an infection – urinary tract infections (UTIs) are a common cause in elderly people or people with dementia. a stroke or TIA (“mini-stroke”) a low blood sugar level in people with diabetes – read about treating low blood sugar.
Delirium can last from a day to sometimes months. If the person’s medical problems get better, they may be able to go home before their delirium goes away . Some people’s delirium symptoms get much better when they go home.
Neuroleptics may be needed if the patient is having distressing hallucinations/delusions or. the patient is very agitated. High potency with low anticholinergic activity. Low dose. Haloperidol or risperdone. Benzodiazepine if delirium is secondary to benzo or alcohol withdrawal.
Once an older person is thirsty, they are already mildly dehydrated . Symptoms of severe dehydration include dry mouth and lips, sunken eyes, increased mental status changes and decreased urine output. This is a medical emergency which results in delirium and if not reversed, death ensues.
In contrast to dementia , delirium is typically conceptualized as a reversible process. Delirium is frequently reversible even in patients with advanced illness. However, delirium may not be reversible in the last 24 to 48 hours of life. This is most likely due to irreversible processes including multiple organ failure.
What I learned today: How to care for someone with delirium Surround them with familiar objects and people. A clock provides visual stimulus and helps them keep track. Speak in short, clear, simple sentences. Explain, explain, explain. Check that they’ve heard and understood. Answer each time as if it’s the first. Don’t talk over their head or pretend they’re not there.
Delirium , a medical emergency , requires immediate interventions. Because it represents a drastic change in personality, loved ones often bring these patients to the emergency department. Hospital admission is a common necessity.