Delirium

Definition
Delirium is temporary acute mental confusion that comes on suddenly. Signs and symptoms occur over hours or days and may fluctuate during the course of the day.

Causes
Advanced Age, Medications, Acute Illness, Infections, Metabolic Disturbances, Alcohol or Drug Abuse, Cognitive or Sensory Impairments, Hip Fracture, Surgical Procedures.

1. Medications account for a significant percentage of all episodes of delirium. If sudden acute or increased confusion occurs think medications especially new drugs or a change in dose.
   
   
2. Behavior, whatever its manifestation, is an attempt to communicate something. The in dividual may feel frightened or out of control. Provide familiar foods, activities and visits from friends and loved ones to decrease fear. Keep things simple to promote control over the environment.



3. Limit use of restraints or equipment that interfere with normal mobility and function of the body - avoid any type of restraints.



4. Environmental interventions are very useful in treating the symptoms of delirium. For example, "timelessness," a situation in which there are often no indicators to distinguish day from night, can contribute to disorientation, sleep disturbance, and nighttime agita tion. Turning lights off and on at appropriate times and opening and closing curtains and blinds may help keep the delirious patient oriented to the correct time of day.



5. Large print wall calendars that are kept up to date and large dial analog clocks help with orientation.



6. Repeated, gentle reorientation to time, place and people several times throughout the course of the day may be helpful.



7. Excessive noise should be minimized. Create a soothing quiet environment. Speak softly and calmly. Minimize upset.



8. Delirium may increase with sensory impairment, such as poor vision or hearing. Provide clean eyeglasses and hearing aids. Check that hearing aids are on and batteries work. Test frequently by turning volume to high and listen for a squealing noise, then re-set volume to a comfortable setting.



9. Restraints should be avoided since delirious individuals will not comprehend the reasons for being restrained. Restraint use can contribute to increased fear, paranoia, and agitation, especially in individuals who are already agitated.



10. Family members may be very helpful in calming and reassuring the delirious individual. Pet therapy is also helpful if the individual likes animals.