Delirium is a quick onset brain disorder that cannot be better accounted for by a brain condition previously diagnosed, such as dementia. It causes a short-term confused state and develops quickly over hours and days. Typically, this leads to short term problems with memory, concentration, attention, and personality. It often occurs when a person is medically unwell or following surgery.
People that are living with dementia and other chronic brain disorders are more likely to experience delirium, but this can be more difficult to detect. People may develop delirium in a range of settings whether they are in hospital, in a care home or living at home.
There are many things that can trigger a person to develop delirium. These are normally underlying illnesses, for example: infections, not eating or drinking enough, injury or surgery, pain constipation and side effects to medicines.
It is more common for people who are aged over 65, experience cognitive impairment, who have dementia, or they have had delirium before.
People are more likely to develop delirium if they have recently had surgery, have many medical conditions or they have hearing or sight loss.
To reduce the possible impact of delirium it is important to spot the signs as early as possible. The behaviour of a person with delirium will quickly change, over hours or days.
As soon as you spot any of these signs it is important to speak to a doctor or a nurse as soon as possible.
Here are some of the common signs to watch out for:
- They might be restless and agitated
- They may be withdrawn and drowsy
- They might not recognise family and friends or be orientated to their surroundings;
- They might not be able to concentrate on holding a conversation.
- They might see or hear things which are not there or be suspicious of people around them
The following can help someone with delirium to feel better and get well:
- Encourage them to eat regularly little and often if they are not eating 3 meals a day
- Encourage drinking 6-8 cups of fluids a day
- Encourage them to wear their glass and hearing aids (if they have these)
- Encourage exercise and getting up out of bed but first always ensure this can be done safely to avoid a fall
- Ensure that they are getting a good night’s sleep
- Encourage them to go to the toilet regularly to avoid becoming constipated
- Ask a doctor or a pharmacist to check if they are taking multiple medicines which might be causing a problem
- Check that they are not in pain
- Explain where they are, if they are in an unfamiliar place, write things down to help them remember, use things that are familiar to them such as photographs
- Encourage them to engage in activities and hobbies that they like
- Use clocks and newspapers to remind them of the date and time
Most people do recover but this may take a long time (days to weeks). As the underlying illness is treated the person will slowly come back to their normal self. They might struggle with day-to-day tasks for a few days or weeks.
Someone who has had delirium once has an increased risk of developing it again. Continue to do everything that is in the list above to reduce the risk of them developing delirium again, and remember to always speak to a doctor or nurse if you spot the signs of delirium.
Some people have symptoms that never go away. If they still have problems with thinking or remembering things after several months, speak to a doctor or a nurse to ensure they are further assessed.
Below are links to further resources which may be useful: