Delirium

What is delirium?

Delirium is when symptoms of confusion occur suddenly, usually over one to two days. It can affect us at any age, but is more common in older people, those living with dementia, strokes or Parkinson disease.

The key question is: Are they different today? If the answer is yes, they may have delirium.

Symptoms of delirium

new or increased confusion
disorientation: not recognising familiar people or places
poor concentration and memory problems
drowsiness and or excessive sleeping, withdrawn
feeling unsettled or restless, sometimes being aggressive or irritable
feeling frightened or anxious
hallucinations: seeing or hearing things that aren’t real
vivid dreams
paranoia and false beliefs (delusions) for example thinking things are happening when they aren’t
problems with talking and mixing up words
sudden poor mobility and falls, and loss of appetite
changes in sleep pattern such as being more awake at night

Causes of delirium?

There are a number of possible causes of delirium and these are some of the most common:

pain
infection eg chest or urine infections (UTI)
poor appetite and not eating well
a vitamin deficiency in your body such as B12
constipation
not drinking enough fluids
some medications can cause delirium, as can taking a lot of different treatments
being in an unfamiliar place such as a hospital
sight or hearing problems
surgery
being near the end of life

What you should do

Delirium is often caused by an underlying medical problem and can be serious. It is essential to seek medical help as soon as possible. If the person is at home contact their GP and request an urgent appointment or contact NHS 111.

if they are in hospital, tell the nurse or doctor who is looking after them.
if they live in care home tell a member of staff.
if you think the person is seriously or suddenly unwell take them to A & E or call 999 for an ambulance.

Treatment for delirium

If a person is experiencing delirium, it is important for a doctor to check for what might be causing it. They may want to do tests for the causes mentioned above and will also ask about how the person usually is. Once the underlying cause is treated, 60% of people will recover within a week. Others do take longer and some may not return fully to how they were before. This is more likely if they also have dementia.

Delirium vs dementia

Delirium symptoms happens in a short space of time, and can be treated and reversed. Dementia symptoms are from progressive diseases such as Alzheimer’s disease. Some types can be slowed and managed with medication but they cannot be treated and reversed.

Acknowledgements

Thank you to Tees Esk Wear Valley NHS Mental Health Trust for allowing us to use their video on Delirium.

Last updated: March 14, 2024