Caring for Someone with Delirium

This information explains what delirium is and will help you care for a friend or family member with delirium.

About Delirium

Delirium is a sudden change in the way someone thinks and acts. People with delirium can’t pay attention to what’s going on around them, and their thinking isn’t organized. This can be very frightening for the person with delirium, their family, and their friends.

Delirium may develop in a matter of hours or over several days. The symptoms can come and go. In almost all cases, delirium is caused by a medical condition.

Delirium and dementia aren’t the same thing. Unlike dementia, which is a chronic condition, delirium will usually get better with treatment.

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Symptoms of Delirium

Many people with delirium seem confused. They may:

  • Be restless and upset
  • Be agitated
  • Seem troubled
  • Be paranoid
  • Be more alert than usual
  • Have trouble staying awake
  • Look or act depressed
  • Not make sense when speaking
  • See or hear imaginary things
  • Mix up days and nights
  • Be forgetful
  • Have trouble focusing
  • Not know where they are
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Causes of Delirium

Delirium can be caused by different things. Some common causes are:

  • Infection
  • Side effects of medications, or a change in medication
  • Recent surgery with anesthesia (medication that makes you sleep)
  • Chronic illness that’s getting worse
    • A chronic illness is a disease that goes on for a long time and often doesn’t go away completely, such as chronic kidney or liver disease.
  • Low or high levels of sodium, potassium, calcium, or magnesium in the blood
  • Dehydration
  • Not eating well over a long period of time
  • Low or high blood sugar
  • Constipation
  • Not being able to urinate
  • Pain
  • Drinking too much alcohol, or a sudden withdrawal from drinking alcohol
  • Withdrawal from benzodiazepines or other sedative-hypnotic medications (medications that relax you)
    • Lorazepam (Ativan®), alprazolam (Xanax®), and diazepam (Valium®) are common benzodiazepines.
  • Not getting enough vitamin B1 (thiamine)
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Risk factors for delirium

A person may be at risk for delirium if they:

  • Are over the age of 70
  • Have had delirium in the past
  • Have memory or thinking problems
  • Have a severe illness and need to stay in a hospital
  • Are dehydrated
  • Have a lot of vomiting or diarrhea
  • Have problems seeing or hearing
  • Take 5 or more different medications
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Treatment of Delirium

The best way to treat delirium is to find and treat the thing that’s causing it. Sometimes, several tests are needed to find the cause. These tests can include blood tests, x-rays, brain imaging, and electrocardiograms (EKGs). The doctor or nurse will also ask questions about the person’s medical history (past illnesses, treatments, and other things related to their health).

Once the cause of the delirium is found, treatment can start. If the person is upset or nervous, they may be given medication to help them relax. Medical equipment that isn’t needed will be taken out of their room to help them feel more secure. Some people will also have someone in their room to make sure they’re safe.

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How to Help a Person with Delirium

You can help the person with delirium in many ways, including:

  • Encouraging them to rest and sleep.
  • Keeping the room quiet and calm.
  • Making sure they’re comfortable.
  • Encouraging them to get up and sit in a chair during the day.
  • Encouraging them to work with a physical or occupational therapist. The therapist can help them get out of bed and move around.
  • Helping them eat and drink.
  • Making sure they drink a lot of liquids.
  • Making sure they have their eye glasses, hearing aids, or both.
  • Arranging for friends to come visit.
  • Talking about current events or surroundings.
  • Explaining where they are and why.
  • Reading them books or letters.
  • Playing them familiar and calming music.
  • Bringing them familiar items from home.
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Recovering From Delirium

Delirium can last anywhere from a day to months. If the person’s medical problems improve, they may be able to go home before the delirium gets better. Some people’s symptoms will get much better when they return to their familiar home environment. Other people will continue to experience memory and orientation problems months after the delirium’s medical cause has been treated.

Call the person’s doctor or nurse at the first sign of confusion. Their doctor, nurse, social worker, and case manager will help you plan for their care at home.

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