Including 12 tips how family and carers help?
Delirium is a common medical problem that can happen when you become physically unwell. It is also known as “Acute Confusion”. The symptoms of delirium cause sudden changes in mental functioning and people can appear confused and may appear sleepy or restless or distressed. Delirium is thought to occur 4-5 times more often in a person with dementia. The symptoms of delirium can be mistaken for a person’s dementia getting worse, but it is important to recognise and treat delirium in its own right. Once treated the symptoms usually ease within a few days but can persist for longer periods.
What causes delirium?
There are a large number of possible causes of delirium but some of the most common include urinary tract infection, chest infection, surgery, having a high body temperature, side-effects of drugs like pain killers and steroids, dehydration, constipation or being in an unfamiliar place. Older Age and multiple medications also increase risk of delirium
What are the symptoms of delirium?
- Be less aware of what is going on around you.
- Be more confused and forgetful, especially in the evening
- Have difficulty following conversation or to speak clearly.
- See or hear things which aren’t there (hallucinations)
- Worry that other people are trying to harm you
- Have changes in sleeping pattern such as being restless at night and sleepy during the day
- Feel fearful, irritable or upset
How is delirium treated?
If someone suddenly becomes confused, they need a medical assessment by a doctor urgently.
The person with delirium may be too confused to describe what has happened to them, so it’s important that the doctor can talk to someone who knows the person well.
To treat delirium, you need to treat the cause. For example, an infection may be treated with antibiotics.
12 tips how family and carers help?
It can be reassuring for a person with delirium to have a familiar person with them especially if they need to go into hospital. You can also help by
- Speaking in a slow clear voice and keeping sentences short
- Help and encourage the person to take adequate diet and fluids
- Orientate to time and place. Ensure the person can see a clock and calendar if possible
- Promote sleep and relaxation
- Encourage the person to keep mobile
- Keep lighting appropriate for the time of day
- Try and have a quiet environment
- Manage pain and discomfort
- Make sure that the person is wearing their glasses/hearing aids if required
- If the person has unusual ideas or hallucinations try to disagree tactfully or try changing the subject
- Help/encourage the person to maintain activities of daily living such as washing and dressing
- If the person needs to be cared for in hospital bring in personal items such as photographs, handbags, favourite music or own clothing
Delirium is a serious condition if left untreated. Please seek urgent medical help if you notice a change in presentation
I would welcome any hints tips you would want to add to my blog post on delirium?
This week’s blog is by Ruth, an occupational therapist in NHS Forthvalley and also a council member of the Scottish Delirium Association. The Scottish Delirium Association was formed by a group of health professionals working across Scotland. Its aim is to provide a forum for discussion and sharing of best practice. This website provides relevant documents and links.
For further information
Resources and links available at www.scottishdeliriumassociation.com
View Health Care Improvement Toolkit www.healthcareimprovementscotland.org/…/delirium_toolkit.aspx
View a five minute video with Professor Alasdair MacLullich explaining how Scotland is tackling delirium in the care of older people in Scotland, via involvement in Healthcare Improvement Scotland’s programme of work. The video was published on 9 Jan 2014
@ScotDelirium official page of the Scottish Delirium Association to find out more about their work
Team Lead Occupational Therapist, NHS Forthvalley
I work as an Occupational Therapy Team Lead in a Community Mental Health Team for Older Adults within the Falkirk area. As part of my role I work with people who have newly been diagnosed with dementia and their families. I work closely with my Alzheimer Scotland colleagues and do a joint post diagnostic and singing groups with them. I am also involved in dementia training for Allied Health Professional’s in NHS Forth Valley.