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Delirium: What Do I Need To Know?

1

What is Delirium?

Delirium is a sudden change in how someone thinks, acts, or understands what is happening to them. This short term change in a person’s thinking is caused by physical changes in the body. Delirium can be common in older adults when they are in the hospital or a long-term care home. It can happen to someone at home as well. Wherever it happens, it is important to treat it as a medical emergency and get medical help right away.

Is my family member at risk for delirium?

A person can be at higher risk for delirium if they:

  • Are 65 years old or more
  • Already have problems with memory or understanding, or already have dementia
  • Have a broken hip
  • Have a serious illness that is getting worse or is at risk of getting worse
  • Had delirium before
  • Have a history of substance or alcohol abuse

Is delirium the same as dementia or depression?

No – even though delirium happens more often in people who have dementia, they are not the same condition. We can tell delirium apart from the other two conditions by how quickly it starts. Dementia and depression tend to develop over a longer time. Delirium can happen suddenly and can start and stop quickly.

2

What does delirium look like?

Delirium can be tricky to spot because it does not always show up in the same way. Some people can seem drowsy or depressed, while others can become angry or excitable all of a sudden. Someone with delirium might be:

  • Anxious
  • Confused
  • Sleeping more than usual

What does delirium look like? (Cont.)

  • Forget things (names, places, dates, times or other important information)
  • Say things that don’t make sense
  • Have trouble focusing or concentrating
  • See or hear things that are not there
  • Feel physical things that are not there (such as bugs or a burning feeling)
  • Act in unusual ways
  • Have trouble staying still or sleeping
  • Misunderstand what is being said to them

If you notice any of these or that your family member is not acting like themselves, make sure to let the care team know.

What causes delirium?

Delirium can be caused by a number of things, such as an infection, medications (for treating illness or to control pain), or not drinking enough fluids. Delirium can sometimes be caused by one, or a few of these factors.

3

How does Sunnybrook prevent delirium?

Health care teams at Sunnybrook make it a priority to check all patients for risk factors and signs of delirium. We look for factors that make someone more likely to develop delirium and do our best to address them.

These factors include:

  • Hearing or vision problems
  • Not drinking enough fluids
  • Not being able to sleep well
  • Pain that is not controlled well
  • Certain medications
  • History of alcohol or recreational drug use
  • Chemical changes or imbalances in the body
  • Low oxygen level
  • Infections (such as pneumonia)

How does Sunnybrook treat delirium?

Someone with delirium may be scared by their symptoms. Being in an unfamiliar place like the hospital may be confusing and they might have a hard time understanding where they are and what is happening to them.

Our health care team will help the patient stay safe and calm while they have delirium. The team will look for the cause(s) of the delirium and make adjustments to address the risk factors or symptoms your loved one is experiencing.

This might include:

  • Reviewing and changing medications
  • Providing more fluids
  • Correcting chemical problems in the body or treating infections
  • Treating low oxygen levels
4

How can family, friends, and caregivers help?

Pay attention!

You know best what the patient’s ‘regular’ looks like. If you notice any small changes and signs of delirium, let the health care team know right away.

Be a cheer leader!

Find out from the health care team how much the patient should drink – and encourage your loved one to drink fluids often.

  • Help the patient maintain an active mind.
  • Talk with them about current events or your family history.
  • Visit and be present. This is a big help.
  • Speak to them in a calm, reassuring voice to help them feel calm and in control.
  • Tell them where they are and why they are here throughout the day.
  • Bring in some familiar objects from home such as photos and music.

Help the patient maintain an active body.

Encourage them to sit up in a chair, get up, move to the bathroom, or go for an outing away from the room with you. Make sure you check with the health care team to learn about how to safely move with your loved one.

Encourage your loved one to wear their hearing aids or eyeglasses if they need them. Being able to hear and see as usual is important to helping someone stay oriented.

Help them rest and sleep by reducing noise and distractions – and if your loved one is experiencing delirium, it may be a good idea to limit the number of visitors who come and go to reduce confusion.

Last, but not least - take care of yourself!

It can be stressful and tiring to be with a person with delirium even though you now understand the problem more.

Make sure you take care of your own wellbeing:

  • Take breaks and get adequate rest
  • Make sure you eat healthy food and drink fluids to keep your energy level up
  • You may find it helpful to talk to someone about your feelings and thoughts about your experience. The health care team are here to listen and chat if you need.

You can find additional information at these links below:

1. Quick Delirium Info Sheet – Regional Geriatric Program of Toronto

2. Delirium Information Booklet – University Health Network

3. Delirium Discussion guide for families – Health Quality Ontario