This information will help you care for a friend or family member with delirium.

What is delirium?

Delirium is a sudden change in the way someone thinks and behaves. People with delirium cannot pay attention to what is going on around them and their thinking is not 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, there is an underlying medical cause for it. Unlike dementia, which is a chronic condition, delirium will usually get better with treatment.
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What are the symptoms of delirium?

Many people with delirium seem confused. They may:
  • Be restless and upset
  • Be agitated
  • Be paranoid
  • Be more alert than usual
  • Have trouble staying awake
  • Drift between being asleep and being alert
  • Look or act depressed
  • Not make sense when speaking
  • See or hear imaginary things
  • Mix up days and nights
  • Be forgetful
  • Have trouble concentrating
  • Not know where they are
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What are the causes of delirium?

  • Infection
  • Side effects of medications or a new change in medication
  • Recent surgery with anesthesia (medication that makes a person sleep during surgery)
  • Chronic illness that is getting worse (i.e., 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
  • High or low 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 drugs
  • Not getting enough vitamin B1 (thiamine)
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What are the risks for delirium?

A person may be at risk for delirium if he or she:
  • Is over the age of 70
  • Has had delirium in the past
  • Has memory or thinking problems
  • Has a severe illness and is hospitalized
  • Is dehydrated
  • Has a lot of vomiting or diarrhea
  • Has problems seeing or hearing
  • Takes 5 or more different medications
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How is delirium treated?

The treatment of delirium involves treating what has caused it. A patient with delirium may need to have several tests to find the cause. These tests can include blood tests, x-rays, brain imaging, and electrocardiograms (EKGs). Doctors will also get a medical history from the patient’s family.
Once they know what caused the delirium, doctors will begin treatment. They may use medication to calm the patient. Medical equipment that is no longer needed will be taken out of the room to make the patient feel more secure. Some patients will also have a companion in their room to make sure they are safe.
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How can family members and friends help the patient?

Family members and friends can help the patient in many ways, including:
  • Encouraging them to rest and sleep
  • Keeping the room quiet and calm
  • Making sure they are 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 him or her 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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How long does it take to recover from delirium?

Delirium can last anywhere from a day to months. If medical problems improve, some patients will go home before the delirium gets better. Some patients will continue to experience memory and orientation problems months after the underlying medical condition has been treated. Some patients’ symptoms will greatly improve when they return to their familiar home environment.
Call the patient’s doctor or nurse at the first sign of confusion. Their doctor, nurse, social worker, and case manager will help you plan for the patient’s care needs at home.
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