OverviewWhat is delirium?Delirium happens when a person has sudden confusion or a sudden change in mental status. The person may have trouble paying attention or thinking clearly. They may act disoriented or distracted. Show
Delirium is more severe than having a “senior moment” — the minor problems people have with memory and understanding as they get older. It requires treatment and often hospitalization. Is delirium a disease?No, delirium is not a disease. It’s a changed mental state. Is delirium the same as dementia?Delirium and dementia (which includes conditions such as Alzheimer’s disease) have some similarities, but they are not the same.
However, someone can have both delirium and dementia. Seek care quickly if a person, especially one with dementia, begins to show symptoms of delirium. What are the types of delirium?The two types of delirium are:
Hypoactive delirium is more common, occurring in up to 75% of people with delirium. But many people, including healthcare providers, may incorrectly assume the person is depressed. People can experience both types of delirium together. They can be extremely alert one minute and drowsy the next. Who is at risk for developing delirium?Delirium happens more often in older people and hospitalized patients. “Hospital delirium” can affect 10% to 30% of those patients. People in these high-risk populations may develop delirium:
People may also be at higher risk for developing delirium if they:
How common is delirium?Because delirium is temporary, it’s hard to know exactly how many people develop it. Researchers estimate that hospital delirium affects 15% to 50% of people. Symptoms and CausesWhat are the causes of delirium?In some cases, providers can’t find a cause of delirium. Known causes of delirium include:
What are the symptoms of delirium?The different types of delirium produce different symptoms. Symptoms tend to start suddenly and get worse over the next few hours or days. A person with delirium may act like they’re intoxicated. The main symptom is being unable to pay attention. Symptoms tend to become worse in the evening, which is known as sundowning. Symptoms of hyperactive delirium include:
Symptoms of hypoactive delirium include:
Diagnosis and TestsHow is delirium diagnosed?Healthcare providers look for problems with attention, memory, orientation and visual ability. Providers may ask the person to perform a few simple tasks, such as spelling a short word backward or doing a basic math problem. A provider may diagnose delirium if the person:
What tests are used to diagnose delirium?After asking about the person’s symptoms, healthcare providers do a physical exam. They may also use other tests to help identify a cause, including:
Management and TreatmentHow will the provider decide what treatment is best?Other medical conditions usually cause delirium. It’s important to treat those conditions to treat the delirium. The provider will review the person’s:
The person may not be able to answer questions about themselves. So providers may ask the person’s family member or loved one:
Does delirium require hospitalization?In some cases, the person is in the hospital when they develop delirium. If they are not, they will most likely need hospitalization. In a hospital setting, providers can monitor them and keep them from injuring themselves or others. Providers try to identify the cause of delirium quickly to get the patient treatment as fast as possible. Once providers identify and treat the reason, they can often reverse the delirium. A team of multiple providers can help give the best care. It’s important to prevent related problems such as undernutrition and incontinence. A care team may include a:
How is delirium treated?Treatment for delirium depends on the cause. Treatments may include:
A healthcare provider may prescribe antipsychotic drugs, which treat agitation and hallucinations and improve sensory issues. Antipsychotic drugs include:
How can I care for someone with delirium?Often, treatments for delirium focus on the environment. It’s best if the person is in a quiet setting. If you are caring for someone with delirium, try these tips:
How can I help a person with delirium be independent?The person should do as much as possible on their own. They may need some assistance in becoming independent. The person should:
How soon will a person with delirium start to feel better?The symptoms typically improve in a few days to weeks. But someone who had delirium may have to stay longer in the hospital even after symptoms improve. They may still have an underlying medical condition or be unable to function completely on their own. PreventionCan delirium be prevented?Before you or a loved one has surgery, talk to your healthcare provider about assessing your mental status before the procedure. This way, your provider can establish a baseline. If your mental status changes after surgery, providers have presurgical measurements for comparison. And if you or your loved one has risk factors that increase your chances of developing delirium, talk to your provider. These other tips can help prevent delirium:
What conditions put me at risk for delirium?These conditions or situations raise the risk of developing delirium:
Outlook / PrognosisWhat is the outlook for people with delirium?Patients can recover completely if the cause of delirium is identified quickly and addressed. Any delay makes it less likely they’ll recover quickly and/or fully. Lack of treatment can lead to stupor, coma or even death. Older persons with dementia and those with HIV are less likely to have a complete recovery. Is delirium fatal?Delirium can be life-threatening if left untreated. But with the right care and treatment, people can recover. How long does the person need to be on medication?If a person receives medication to treat symptoms of delirium, the symptoms may improve. However, even when symptoms improve, the person should not suddenly stop taking their medications. A healthcare provider can help gradually decrease the dose and eventually stop the medication. Living WithWhat are complications of delirium?People with delirium may also have:
What side effects do delirium treatments have?Antipsychotic drugs come with some side effects, although researchers are working on developing drugs that cause fewer side effects. Side effects are more common in older adults and can include:
Benzodiazepines can cause:
What should I ask my healthcare provider?If a loved one is in the hospital with delirium, ask the provider:
A note from Cleveland Clinic Delirium is a state of mental confusion that starts suddenly. It’s more common in older adults and people who are hospitalized. If you notice a sudden shift in mental status in a loved one — for example, they’re confused, disoriented and distracted — contact a healthcare provider. Prompt treatment can help most people recover fully from delirium. Which action will help the nurse determine whether a patient's confusion is caused by delirium?Use the Confusion Assessment Method (CAM) to identify whether this patient has delirium.
How is delirium confirmed?Physical and neurological exams.
The doctor performs a physical exam, checking for signs of health problems or underlying disease. A neurological exam — checking vision, balance, coordination and reflexes — can help determine if a stroke or another neurological disease is causing the delirium.
Which symptom would suggest that the patient is experiencing delirium instead of dementia?Delirium is different from dementia. But they have similar symptoms, such as confusion, agitation and delusions. If a person has these symptoms, it can be hard for healthcare professionals who don't know them to tell whether delirium or dementia is the cause.
Which of the following is characteristic of delirium?Restlessness, agitation or combative behavior. Calling out, moaning or making other sounds. Being quiet and withdrawn — especially in older adults. Slowed movement or lethargy.
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