Delirium is a severe disruption of a person’s mental functioning in which there is confusion and little understanding of one’s surroundings. It usually has a rapid onset that can occur between hours and days. This may occur as a result of substance abuse, prolonged mental illness, infection, medication and more.
Symptoms of delirium may be similar to dementia, making a proper diagnosis all the more necessary. These symptoms can include:
Inability to concentrate on a certain subject for an extended period or repeatedly changing subjects
Easily distracted by trivial matters with attention wavering at unexpected times
Impairment of cognitive skills including trouble with reading, writing, speaking or understanding the words of others
Struggles with recalling the recent past
Greater likelihood of anxiety or depression
Increased possibility of hallucinations
Delirium or dementia
There are some distinctions between delirium and dementia that should be noted. For example, those with delirium may experience varying manifestations thereof throughout the day. Symptoms will be more consistent, occurring daily for those with delirium. Those with delirium will also have more problems commanding their attention than those beginning to experience dementia. The quick onset of this condition also makes it different from dementia, which develops progressively.
Causes and types
A number of different characteristics may play a role in leading to delirium. This may include advanced age, insomnia, drug withdrawal, a diet lacking in nutrients, hearing disabilities and visual disabilities. In addition, delirium may have other causes such as medications for a related illness, as well as those for allergies or asthma. Anticonvulsant drugs may also play a role. There may be more than one cause in the patient and oftentimes the symptoms may follow surgery. Delirium symptoms may lead to an overall decline in health and/or the need for inpatient care. Recovery from an operation may be more difficult, along with a greater likelihood of death.
There are often two forms of delirium that may occur. One is hyperactive delirium, which may lead to hyper vigilance, anxiety and arousal. On the other end of the spectrum is hypoactive delirium. This may lead the person to become weary and sluggish, with little knowledge of their whereabouts. These two forms may alternate quickly, sometimes within the same day.
Though delirium often occurs in older people, it can still occur in other age groups as well. One third of older patients in emergency situations are said to suffer from it. Those that live at home will have a higher risk of delirium as they get older.
Those with delirium will often receive supportive care to assist them in meeting needs such as nutrition, pain management, movement skills and understanding one’s surroundings. Calendars and a clock may help the patient to better keep track of time. One may place familiar items in an area to assist the individual with delirium. In order to reinforce healthy circadian rhythms, therapy will seek to encourage sufficient sleep at night, with little noise and light. During the day, there should be sufficient light to promote attentiveness in the daytime. Relaxation methods may prove therapeutic, along with allowing the client to attend to simple aspects of their own care. Keeping the same caregivers and environment will help to minimize confusion.
Single rooms should be made available to those who are suffering from delirium. The individual should not be in an environment with excessive noise or without controlled temperatures. Health advocates may be necessary in certain situations to ensure the patient’s well being as they may wander which should be prevented for the person’s safety.
In prescribing medication, it will be important to discuss options with one’s doctor that should be avoided, as some will exacerbate symptoms. However, it may be necessary to calm a patient who is experiencing hallucinations or paranoia. Those who become a danger to themselves or others may undergo drug treatment, as well as undergo a specific medical test.
In dealing with those who suffer from delirium, it will important to simply address changes in activities. He or she should always be approached in a calm manner and confrontations should be avoided. The patient should be encouraged to take their medication regularly. It may also prove helpful to maintain a healthy diet and regular exercise.
Eventually, those with delirium will be discharged from an inpatient program. It will be necessary to understand that symptoms may continue to persist. Oftentimes, depression, lack of attention and disorientation will continue to be challenges regardless of the length of treatment. Therefore, it will important for friends and family to continue to offer support and understanding.
For those who are struggling to maintain their mental health, Sovereign Health Group can help. To learn more about our mental health programs you can call us at 866-754-3385 to speak to a member of our team.
Contributed by Sovereign Health Writer, Ryan McMaster