Delirium is a sudden change in a person’s mental abilities which can cause confusion, disorientation or lack of concentration. These symptoms can appear very suddenly (usually in a matter of days).
Dementia is the biggest risk factor for delirium. Older people in hospital can also be at risk of delirium.
Symptoms of delirium can vary throughout the day and include:
Being less alert
Being distracted
Being disorientated, such as not knowing where they are
Suddenly being unable to do things they can normally do, such as eating or walking
Sudden changes in mood
Paranoia – thinking that someone is out to get them or accusing someone close to them of wrongdoing
Being restless
Hallucinating
There are several types of delirium:
Hyperactive – very active
Hypoactive – not active enough
Mixed – where a person can switch from one type to the other during the day
During hyperactive delirium, a person may hallucinate or think that someone is trying to harm them.
Hypoactive delirium means the person will be withdrawn or tired. Mixed delirium means the person will have symptoms of both.
Key causes include:
Dementia
Pain
Age
Infections such as urinary tract infections
Dehydration
Poor appetite
Constipation
Surgery
Multiple medications
Sight and hearing problems
Organ failure
Delirium should be diagnosed and treated swiftly, as it can be life-threatening. If you suspect signs of delirium, it’s important to seek medical help immediately. If you can’t get the person’s GP to see them, call 111 for advice or call 999 if the person suddenly becomes very confused.
You can check the following:
Alert – is the person tired or agitated
Aware – do they know their age or where they are
Attention – are they able to focus on a task
Acute – do their symptoms come and go?
Seek medical help right away
Don’t leave the person alone
Let the person know you will stay with them until they receive help
Tell the person who you are if need be
Speak slowly and calmly, and use short sentences
Reassure the person as much as necessary
Avoid changing their routine
Avoid stimulation such as lights, noise or too many people
Make the person drinks to keep them hydrated
You can reduce the risk of delirium by:
Keeping the person well-hydrated
Make sure they take their medication
Sticking to their usual routine to minimise confusion
Lewy body dementia can cause visual hallucinations, which can come and go throughout the day. Delirium can be harder to spot in a person with Lewy body dementia as symptoms are similar.