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Home > Spotting the signs and stopping delirium

Spotting the signs and stopping delirium

Spotting the signs.

There are different signs you can look for which may help to answer the question, “Have they been more confused lately?” 

Disorientation or alertness

A person can become disorientated when they are experiencing delirium. They might not know:

  • The date.
  • The month.
  • The year. 
  • The time of day.

They might not know where they are or may not recognise those they know. Sudden reduced concentration and alertness can occur. Their family or carers may find them to be overactive (hyper) or quite lethargic (hypo) or difficult to wake up.

Behaviour or thinking

Changes to behaviour or the way the person communicates is common.

The family may find it more difficult to follow the person’s conversation. They might change the topic of conversation a number of times or be distracted easily. Disorganised thinking and a feeling of being misunderstood can make the person feel frustrated and act in an aggressive way.

Hallucinations

The person may suddenly start having hallucinations (seeing or hearing things that are not there) or talking about strange experiences. Their hallucinations and thoughts can be very frightening, and the person may act to escape them.

Delusions

The person might become suspicious. They may think they are being watched (this may make them frightened of dealing with other people). Or they might think their food and drinks are being poisoned.

People who have experienced delirium say they:

  • Felt unsure of their whereabouts.
  • Worried that other people were trying to harm them.
  • Felt afraid, irritable, anxious or depressed.
  • Felt slow and sleepy.
  • Felt agitated and restless.
  • Had vivid dreams that continued when they woke up.
  • Found it hard to understand what someone said.
  • Found it difficult to speak clearly.
  • Saw and heard things that were not there.

Video

Watch the video below from Dr Mani Krishnan, hashtag ‘icanpreventDELIRIUM’ for more information.

Stopping delirium

It is the treating doctor’s job to identify and treat the underlying cause of delirium. This could be pain, constipation or another cause. They should make sure the person is well hydrated, has good hygiene and follows advice about wound care or medical devices (like catheters).

The doctor may request blood and urine tests and will be able to decide on appropriate treatment. Additionally, they may want to review any medication that could be contributing to the delirium.

There is no specific medical treatment for delirium itself, but there are ways to manage the symptoms linked to it.

How long does delirium last?

Symptoms usually get better over a few weeks. Symptoms of delirium can last for up to 6 months. This can even be the case if the underlying symptoms have been treated.

Importantly, most people recover completely from an episode of delirium. However, some people may experience lasting problems.

a huge number of clocks.
  • Sometimes people can remember their experience of delirium. This may include frightening and upsetting memories. Reassurance and explanation can help support the person and their family. 
  • Delirium can worsen people’s mental function. They may need more support with their day to day lives and some people may need 24-hour residential care. 
  • Having delirium increases risk of death in the following year. Delirium can increase a person’s care needs. It can also cause poorer health.
Important:
Important information

After one episode, physical illness may cause delirium to return. It is important that, if you think delirium is returning, to act fast and seek treatment for the physical illness trigger. This may prevent the delirium becoming worse. 

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