People who already have dementia or are particularly frail are at higher risk of acquiring the condition. Once in hospital, delirium can be caused by a combination of numerous factors, including surgery, infection, isolation, dehydration, poor nutrition and medications such as painkillers, sedatives and sleeping pills.
In fact, it’s pretty common for it to take weeks — or even months — for delirium to completely resolve in an older adult. In some cases, the person never recovers back to their prior normal.
Delirium may last only a few hours or as long as several weeks or months. If issues contributing to delirium are addressed, the recovery time is often shorter.
Being ill, particularly when it involves taking drugs for pain or anxiety, can make anyone confused. The hospital environment adds to the problem. There, people give up their personal effects and clothing—marks of their identity—for a hospital gown.
How to Help a Person with Delirium
Treating delirium involves providing good basic care, such as ensuring patients are getting enough fluids and nutrients. It also includes reorienting them to their surroundings. Family members should ensure elderly patients have their hearing aids, dentures, glasses or whatever else they need to engage their senses.
However, sometimes delirium is part of the final stages of dying —so-called terminal delirium or terminal restlessness—and it becomes an irreversible process that is often treated symptomatically, with the goal of providing comfort (i.e., sedation) instead of reversing the syndrome.
Delirium prevention strategies include early and frequent mobility (particularly during the day), frequent orientation, sleep management, ensuring the patient has glasses and/or hearing aids on, fluid and electrolyte management, and effective pain management.
ICU psychosis is a temporary condition and can be treated. There is no difference between ICU psychosis and delirium.
Though delirium can happen to anyone, it is most concerning in elderly patients. It is an acute change, one that happens in a matter of hours or days, and should be considered a medical emergency.
Delirium, or a confused mental state, occurs suddenly. A person has a change in mental status and acts disoriented and distracted. Delirium is more common in older adults, especially those with dementia, and people who need hospitalization.
Hospital-induced delirium is an often ignored or underdiagnosed illness affecting a large number of senior patients. The condition is a temporary form of cognitive impairment that can last anywhere between a few days and a few weeks.
Among precipitating factors, drugs (especially sedative hypnotic agents and anticholinergic agents), surgery, anesthesia, high pain levels, anemia, infections, acute illness, and acute exacerbation of chronic illness are the most commonly reported.
Delirium typically goes away in a few hours to a few days or several weeks or months. During its entire course, it may disappear and come back again. The doctor can advise the person to stay in the hospital for some days so that they can monitor their symptoms.
Delirium often clears in a few days or weeks. Some may not respond to treatment for many weeks. You may also see problems with memory and thought process that do not go away. Talk to your health provider about your concerns.
The cause of dehydration is multifactorial, related to swallowing difficulty, lack of thirst, cognitive impairment, physical limitations (including restraints), and misuse of diuretics (3). Dehydration is both a predisposing and precipitating factor for delirium or acute confusional state (4).