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What is delirium?

Delirium 
Delirium is hard to define, but is a condition where patients become confused, upset or not able to think clearly. Often, family members say that patients just “aren’t themselves.”  

Delirium is not the same as dementia (even though they are both problems thinking). 

  • Delirium happens over hours to days
  • Dementia happens over months to years
Dementia does increase the risk of getting delirium while in the hospital.


Diagnosis
There is no specific blood test or imaging to diagnose delirium. Doctors make the diagnosis based on symptoms, including:

  • Confusion (not thinking clearly)
  • Hallucinations (seeing or hearing things that aren’t there)
  • Agitation (acting upset)
  • Severe sleepiness or trouble waking up
  • “Picking” at sheets, clothes or medical equipment


Patients sometimes describe delirium as feeling like they are in a deep hole or underwater. Some remember feeling like they are in a dangerous situation that they need to get out of. One patient described it as “like looking through a kaleidoscope.”


 
Prevention
The best way to manage delirium is to keep it from happening in the first place.

Friends and families are encouraged to work with nursing staff to help prevent delirium:

  1. Keep windows open and lights on during the day. Light helps “set” the body’s internal clock.
  2. If patients have glasses or hearing aids, make sure they are in place and working.
  3. Remind your loved one of where they are, what day it is, and why they are in the hospital.
  4. Try to let patients sleep at night. Sometimes urgent medical procedures will need to take priority over sleep, but, if possible, don’t wake patients unless necessary.
  5. Have a clock where the patient can see it.
  6. Be supportive of nurses, physical therapists and occupational therapists who will help your loved one get out of bed and move as much as possible.
Some patients also find familiar music to be soothing, or may enjoy watching a favorite program on TV.

Treatment
Right now, there are few good treatments available for delirium. Most of the available interventions focus on prevention. For their safety, patients may require chemical sedation (medications to keep them sleepy) or short-term restraints.