Delirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness. A person has a change in mental status and acts disoriented and distracted. It is more common in older adults, especially those with dementia, and people who need hospitalization. Prompt treatment is essential in helping a person with delirium recover.
The two types of delirium are:
• Hyperactive delirium: The person becomes overactive (agitated or restless).
• Hypoactive delirium: The person is underactive (sleepy and slow to respond).
Delirium affects your mind, emotions, movements, and sleep patterns.
You might have a hard time concentrating or feel confused about what’s happening around you. You may also move more slowly or quickly than usual, and experience mood swings.
Symptoms tend to start suddenly and get worse over the next few hours or days. A person with delirium may act like they’re intoxicated. The main symptom is being unable to pay attention. Symptoms tend to become worse in the evening, which is known as sundowning.
Symptoms of hyperactive delirium include:
• Acting disoriented.
• Rapid changes in emotion.
• Trouble concentrating.
Symptoms of hypoactive delirium include:
• Decreased responsiveness.
• Flat affect.
Is delirium the same as dementia?
Delirium and dementia (which includes conditions such as Alzheimer’s disease) have some similarities, but they are not the same.
• Delirium mostly affects a person’s attention. Dementia affects memory.
• Delirium is a temporary state that begins suddenly. Dementia is chronic (long-term) confusion that usually begins gradually and worsens over time.
It could happe when stressors like inflammation or infection interfere with your brain function. There are many possible causes.
The condition is very common among older adults who need hospital care.
Any condition or factor that significantly changes your brain function can cause severe mental confusion. These include –
• certain medications, such as sedatives, blood pressure medications, sleeping pills, and pain relievers
• acute illness
• worsening symptoms of a long-term (chronic) illness
• lack of oxygen — for example, breathing difficulties from asthma
• blocked arteries (ischemia) — for example, in the brain or heart
• severe pain
• sleep deprivation
• metabolic issues, such as low blood sugar or an electrolyte imbalance
• alcohol withdrawal in people with long-term, heavy alcohol use
• surgery or general anesthesia
Medication side effects are a major cause of delirium. Up to 39% of the time, delirium is caused by medications.
Risk factors –
Any condition that results in a hospital stay, especially in intensive care or after surgery, increases the risk of delirium, as does being a resident in a nursing home. Delirium is more common in older adults.
Examples of other conditions that increase the risk of such disease includes:
• Brain disorders such as dementia, stroke or Parkinson’s disease
• Previous delirium episodes
• Visual or hearing impairment
• The presence of multiple medical problems
People with delirium may also have:
• Longer hospital stays.
• Medical complications, such as pneumonia and pressure ulcers.
• Distressing memories of delirium, along with feelings of anxiety or fear.
• Higher chance of needing full-time care.
• Worsening mental abilities.
After asking about the person’s symptoms, healthcare providers do a physical exam. They may also use other tests to help identify a cause, including:
• Blood test.
• Urine test.
• Imaging tests, including chest X-ray, CT or MRI scan.
The goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. The person may need to stay in the hospital for a short time.
Stopping or changing medicines that worsen confusion, or that are not necessary, may improve mental function.
Treatments may include:
• Antibiotics for infections.
• Fluids and electrolytes for dehydration.
• Benzodiazepines for problems due to drug and alcohol withdrawal.
A healthcare provider may prescribe antipsychotic drugs, which treat agitation and hallucinations and improve sensory issues. Antipsychotic drugs include:
• Haloperidol (Haldol®).
• Risperidone (Risperdal®).
• Olanzapine (Zyprexa®).
• Quetiapine (Seroquel®).
How can I care for someone with delirium?
Often, treatments for delirium focus on the environment. It’s best if the person is in a quiet setting. If you are caring for someone with delirium, try these tips –
• Promote good sleep habits: During the day, keep them awake, and expose them to sunlight. Avoid naps. Help them sleep at night by reducing noise and distraction.
• Provide reassurance: Help them understand their environment. Explain what is happening.
• Bring familiar objects: Surround them with items from home, such as photos, a blanket or a bedside clock. These things will help the person feel more comfortable in the environment. Try soothing music as well.
• Encourage eating: Make sure the person eats and drinks nutritious food throughout the day, if appropriate.
• Encourage movement: If it’s safe, help the person get out of bed and move around.
• Help orient them: Talk about current events and family news to provide mental stimulation. Reading out loud can be helpful as well.
For more informative articles on Mental health and other health related issues, please visit our website www.santripty.com and also feel free to consult with our experienced team of doctors, get benefits and stay healthy.
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