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.
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.
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.
It may take weeks or months to fully recover from both the physical and mental problems related to ICU delirium. For some, these problems can last the rest of their lives. This can lead to needing full-time care from a family member, having to live in a care facility, or even dying sooner.
Delirium is a sudden change in mental status characterized by confusion, disorientation, altered states of consciousness (from hyperalert to unrousable), an inability to focus, and sometimes hallucinations. It’s the most common complication of hospitalization among older people.
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.
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.
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.
How to Help a Person with Delirium
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).
Delirium comes on quickly, in hours or days. Signs of delirium can change from one day to the next. Delirium can make memory and thinking problems worse. Delirium usually clears up after a few days or even a week.
While the exact causes of ICU delirium are not fully understood, risk factors seem to include ventilation, which can reduce the flow of oxygen to the brain, and heavy sedation, especially with benzodiazepines, which can have neurotoxic effects.
Delirium in ICU Patients For most people, delirium doesn’t last long – usually only a few days. There are many reasons for someone to develop delirium such as infection, certain medicines and problems with blood sugar.
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.
Tips for Communicating with a Confused Patient
Common causes include delirium, dementia, substance-induced hallucinosis, primary psychiatric illnesses, CBS, and bereavement. Some underlying causes, such as ophthalmologic disease, delirium, and drug-induced hallucinations, are reversible, especially with early identification and definitive treatment.