What is it about ?
Delirium is a sudden confusion caused by a disturbance in the normal functioning of the brain. This confusion is caused by a physical cause or excessive stress. Possible causes are a serious infection, the use of certain medications, heart or blood vessel disease, brain damage, a serious accident, or drastically stopping excessive alcohol consumption.
Some people are more likely to develop delirium: the elderly, people with memory disease and those with serious illnesses such as cancer. Likewise, reduced vision or hearing, physical limitation, insomnia, or staying in a foreign environment increases the risk of delirium. People who take a lot of medication or have had surgery are also more vulnerable.
What is its frequency?
Delirium is found in about 10 to 40% of older people admitted to hospital.
How to recognize it?
The acute confusion is not easy to recognize. Even doctors only recognize delirium in half of the cases. Delirium occurs suddenly, and symptoms change throughout the day: at times the person is fine, but at others they may suddenly be very confused.
A person with acute confusion behaves strangely. It is impossible to have a normal conversation with her. Often she sees people or things that are not there. She forgets, sleeps a lot during the day and is awake at night, does not remember where she is or what day it is. She can be very agitated or, conversely, very listless. The mood can also change suddenly: the person reacts with anger at one time, and at another time, they are sad or suspicious.
Delirium is not a dementia. Dementia develops much more gradually. However, a person with dementia is more likely to develop delirium.
How is the diagnosis made?
The doctor will check with family and others around when the person is confused and how the symptoms started. He will ask how memory was before the confusion arose. He will also ask what medications the person is taking and if they are used to drinking alcohol. The doctor will perform a clinical examination.
To identify the cause of the delirium, additional tests are often necessary, such as a blood test, an x-ray of the lungs, a lumbar puncture, a brain scan, and measurement of the electrical activity of the brain.
What can you do ?
It is helpful if the person is in a quiet, well-lit room and approached in a calm manner. Familiar objects in the environment help recovery.
What can the doctor do?
The doctor will treat the underlying cause of the acute confusion and closely monitor the person’s general condition. If necessary, the person will be hydrated and given oxygen. Unnecessary drugs are stopped. The doctor takes steps to prevent pressure sores and to ensure that the person with delirium cannot injure themselves.
He can prescribe medication for agitation and anxiety. Often it is necessary to administer medicines used in psychosis (eg haloperidol). Sometimes it is necessary to give sleeping pills temporarily. Medicines called benzodiazepines also reduce anxiety.
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