Delirium

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Diane Gravel, RN, BScN, CPMHN(C)

Community Mental Health Nurse

Tri-County Mental Health Services

Delirium is a temporary mental disturbance, meaning if recognized it can be reversed and should be considered a medical emergency. It can be difficult to detect especially in hospital when staff do not know the baseline for this person. Having dementia would be a factor in missing a possible delirium.

It is important to know that it is the change in the previous level of functioning that is the key. If a person is already struggling with memory challenges you have to understand that this is a change in their baseline functioning or what is considered normal for them.

Some of the causes and risk factors of delirium are new medications, some kind of infection, discomfort, dehydration, sensory impairment, previous episode of delirium, cognitive impairment, multiple chronic medical conditions and social isolation.

Here are some of the symptoms you might see if a person is suffering from a delirium:

1. Acute sudden onset of a change in the person’s presentation.

2. Disturbance in sleep wake cycle (a change from that person’s usual pattern).

3. Change in appetite and ability to pay attention.

4. The person seems more mixed up and confused with changes in speech.

5. When delirious you can hallucinate (seeing or hearing things that cannot otherwise be explained).

6. One of the key symptoms is the “fluctuating level of consciousness,” meaning the person could have very clear moments alternating with very confused times. This can fluctuate in the hour or day. They may be talking and alert one moment and then sound asleep moments later.

What can you do if you suspect someone is suffering from a delirium? It is important to act quickly to find and treat the underlying cause. Simple things like keeping the person hydrated, minimizing the noise level and making the surrounding as familiar as possible. If possible provide a consistent caregiver. Use night lights and try to remain calm and supportive. The person suffering from a delirium can experience many frightening moments and will benefit from these comfort measures.

The prognosis for delirium is related to prompt recognition and appropriate management of underlying cause(s). Approximately 70 percent of delirious patients can be expected to have full recovery, with a mortality of 20 to 30 percent. Understanding the risk factors and early intervention is related to the best outcomes.

Talk to your doctor if you are concerned, delirium is a medical emergency that needs to be detected and treated for optimal outcomes.

For more information or to receive the French version of this article, or to seek professional advice, please call 613-932-9940 or 1-800-465-8061. Free, confidential services are available in French and English to residents of Dundas, Stormont and Glengarry through their offices in Winchester, Cornwall and Alexandria.

Keeping Health in Mind is a monthly newspaper column made possible with the help of Seaway News and the clinical staff of Tri-County Mental Health Services, a community program of the Cornwall Community Hospital/Hôpital Communautaire de Cornwall.

Keeping Health in Mind is a monthly newspaper column made possible with the help of Seaway News and the clinical staff of Tri-County Mental Health Services, a community program of the Cornwall Community Hospital/Hôpital Communautaire de Cornwall.

Organizations: Tri-County Mental Health Services, Seaway News, Cornwall Community Hospital/Hôpital Communautaire de Cornwall

Geographic location: Dundas, Winchester, Alexandria

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