Lone Sloane: Delirius

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Some medicines taken alone or taken in combination can trigger delirium. These include medicines that treat: We try to make sure that people get the right level of support when they leave hospital. This includes rehabilitation to improve, restore and maintain their everyday skills and mobility.

It is not always possible to prevent delirium. However, if you're at risk of delirium, there are some things that you can do to reduce the risk yourself. These things can also help you to recover from delirium when you're in hospital. People with delirium might be confused or agitated and act differently than usual. They can seem alert or drowsy (sleepy). They might also have memory problems or see and hear things that are not there. tips for family caregivers. Caregiver Action Network. http://caregiveraction.org/resources/10-tips-family-caregivers. Accessed Sept. 19, 2022.As you get older, you are more likely to have delirium. People who are over 80 years old and have been diagnosed with some type of dementia are particularly at risk. However, delirium can happen in younger people as well, especially if they are critically ill or after surgery. Symptoms of delirium Some people may become paranoid (suspicious) and mistrustful of the people around them. These thoughts can sometimes become distressing. Symptoms of delirium usually begin over a few hours or a few days. They typically occur with a medical problem. Symptoms often come and go during the day. There may be periods of no symptoms. Symptoms tend to be worse at night when it's dark and things look less familiar. They also tend to be worse in settings that aren't familiar, such as in a hospital. Francis J Jr. Delirium and acute confusional states: Prevention, treatment, and prognosis. https://www.uptodate.com/contents/search. Accessed Sept. 19, 2022. If you are concerned about anything after going home, please speak to staff at your outpatient appointment or your GP. Useful sources of information

Family members and carers have an important role. They can help to manage delirium in hospital or at home. Delirium can be a frightening condition for those who have it, together with their family and carers. Not everyone remembers delirium, but those that do may find the memories distressing. Some people may have memory loss. Problems with short-term memory are particularly common. People with delirium may not remember what has happened or where they are. Sleepiness We can often tell that my father is getting a urinary infection because he starts to get slower and becomes quiet and withdrawn. He also sleeps much more.” Agitation or restlessness

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My wife has mild dementia, but we usually manage fine at home. She still recognises most of our neighbours and friends. When she was in hospital, though, she did not even recognise me or our daughter.” Unusual thoughts Delirium often occurs in people with dementia. However, episodes of delirium don't always mean a person has dementia. Tests for dementia shouldn't be done during a delirium episode because the results could be misleading. Depending on how bad the delirium is, a person may need to go into hospital for treatment and management. For others, delirium can be treated at home. Delirium can have different causes. We may need to do medical tests to help decide what treatment is needed.

Hyperactive delirium. This may be the easiest type to recognize. People with this type may be restless and pace the room. They also may be anxious, have rapid mood swings or see things that aren't there. People with this type often resist care. The nurses told me that my grandmother had been up all night, wandering around the ward and trying to leave. However, when I visit her on the ward in the daytime, she is nice and quiet and seems OK.” Physical changes When a person leaves hospital after delirium, they may need more support than usual. They may be at higher risk of falls and need some changes in the home to make sure that their environment is safe. Delirium and dementia may be hard to tell apart, and a person may have both. Someone with dementia has a gradual decline of memory and other thinking skills due to damage or loss of brain cells. The most common cause of dementia is Alzheimer's disease, which comes on slowly over months or years. The doctors and nurses test for and manage any causes of delirium that can be treated. Examples are:Delirium (sudden confusion) usually affects people’s brains for a short time. It is a common condition. Up to 1 in 3 people admitted to hospital become delirious at some time during their stay. Recovery depends to some extent on the health and mental status before symptoms began. People with dementia, for example, may experience an overall decline in memory and thinking skills after a delirium episode. People in better health are more likely to fully recover. Delirium usually gets better. In 6 out of 10 people (60%), the symptoms disappear within 6 days. Others may have some symptoms for longer. About 1 in 20 people (5%) may still have delirium more than a month after they first had symptoms.