Delirium

Delirium is confusion that comes about very suddenly, occurring in as little as a few hours. It is a result of changes in your brain’s function that can happen during mental or physical illness. Delirium may also be referred to as acute confusional state or acute brain syndrome.

Delirium Vs. Dementia

Many people confuse dementia and delirium because they share similar symptoms. Dementia is the result of brain cell loss. This loss of brain cells causes the sufferer to have decreased cognitive skills and memory. Dementia is most commonly caused by Alzheimer’s disease, and most people who experience delirium have dementia.

The severity of symptoms related to delirium can vary greatly on any given day. However, symptoms of dementia generally remain at the same level, though some days may be worse than others. In the early stages of dementia, the sufferer is usually able to remain alert. In the case of delirium, you may notice that the person has little capacity to pay attention. Delirium also appears much more quickly than dementia.

Signs of delirium can appear and dissipate throughout the day. This means that during some periods, someone with delirium may not show any symptoms. You may start to suspect someone you know has delirium if he or she:

• can’t stay focused on one topic
• have problems remembering recent events
• have problems speaking or understanding speech
• ramble
• can’t move on from a specific idea
• have problems writing or reading
• don’t know who they or other familiar people are

Changes in the personality or emotional state of someone with delirium can include:

• anger
• anxiety
• agitation
• depression
• irritability

When to Seek Medical Attention

If you know or are caring for someone who is showing signs of delirium, take him or her to a doctor. Make note of the changes you’ve witnessed. This information can help with diagnosis.

Both physical and mental illnesses can cause delirium. The most common cause of delirium is dementia. Delirium tremens (DT), a severe form of alcohol withdrawal, is another common cause of delirium. DT can cause both mental and nervous system changes.

Septic shock can also cause delirium and confusion. Septic shock is a condition that occurs when serious infection spreads throughout the body. Septic shock causes your blood pressure to become dangerously low.

Delirium is less commonly caused by:

• chemical or nutritional imbalances in the body
• medication use such as anticholinergics
• poison
• surgery

Those with a history of stroke or dementia have an increased risk of developing delirium after an infection such as pneumonia. A loved one who is reaching the end of his or her life or has a life-threatening illness is at exceptionally high risk for delirium.

The primary focus of treatment for delirium is treating the cause of the delirium. This means that if your loved one’s delirium is caused by a certain medication, his or her doctor might suggest discontinuing use. If an infection is causing the delirium, drugs to fight the infection might be given along with rehydrating fluids.

In extreme cases, your loved one’s doctor may feel that treatment with medication to lower blood pressure, fight infection, or address clotting problems is best. This usually only happens when someone is becoming extremely confused. Extreme confusion can lead to severe agitation, which could cause the person to hurt him or herself or others.

You can help someone with delirium to stay oriented. This will decrease his or her confusion and symptoms. For example:

• Keep calendars and clocks visible.
• Try to avoid changing the person’s surroundings.
• Involve familiar family members whenever possible.
• Play music and use relaxation techniques to reduce agitation.

The following tips can help prevent delirium in a loved one suffering from dementia:

• Talk about what time and date it is.
• Get your loved one involved with activities that stimulate the brain, such as playing a game.
• Try not to interrupt his or her sleep.
• Make sure that the person with delirium has enough water and proper nutrition, which can help prevent vitamin imbalances and dehydration in the body that may lead to delirium.