How delirium causes harm

Delirium is a medical emergency. It has a big effect on the health of older adults. Studies have shown that delirium may:

• Cause a decline in day-to-day living

• Make a person unable to care for themselves

• Lead to extra days in the hospital

• Lead to a higher risk of falls

• Mean a higher risk of dying within 6 to 12 months

• Put a person at higher risk of long-term mental health problems

• Greatly increase the risk of dementia in a person without dementia

• Be the first sign of dementia

• Be linked to a person’s dementia getting more severe

• Cause faster mental decline in a person with dementia

• Make a person more likely to live in a long-term care facility

• Cause money problems due to high healthcare costs

Finding the cause

Delirium is treated by finding and treating the cause. It has many possible causes. These include:

• Reaction to medicine or recreational drugs

• Pain

• Poor nutrition

• Constipation

• Trouble emptying the bladder when peeing (urinary retention)

• Dehydration

• Withdrawal from heavy alcohol use or from drugs

• Changes in blood chemistry

• Infection

• Stroke

• Failure of organs such as the liver or kidneys

• Heart disease

• Lung disease or low oxygen levels

• Seizures

A healthcare provider will take a full health history and do a physical exam. They may do tests to find the cause of a person’s delirium. The tests may include:

• Asking questions. This is done to check for cognitive changes.

• Blood and urine tests. These look for signs of infection and changes in blood chemistry.

• Electroencephalogram (EEG). This is a test for seizures and can show patterns indicating other causes of delirium.

• Imaging tests. A CT scan or MRI of the head can check for problems in the brain like bleeding, infection, or a tumor.

• Lumbar puncture (spinal tap). This is done to look for infection of the spinal fluid or brain.

Common treatments for delirium

Once a cause is found, steps are taken to treat the cause. In many cases, the delirium may go away. For example, fluids may be given if the person is dehydrated. Or antibiotics may be given for an infection. And oxygen may be given if the person has low oxygen levels.

It is important to keep the person safe. Removing unneeded IV (intravenous) tubes, restraints, and catheters is often helpful. Make sure they have their glasses or hearing aids in place. Medicines or drugs that can affect the mind should be reduced or stopped. In rare cases, medicines may be given to a person who is severely agitated. Having family members help with care is encouraged. This is because familiar faces are reassuring. The person’s sleep-wake cycle should be restored. To do this, it’s helpful to discourage napping and expose to the person to bright light during the day. 

How long does delirium last?

Delirium may take days, weeks, or months to go away. Delirium may not go away in people with late stages of illness or near the end of life. Talk with the healthcare provider about your loved one’s situation and the treatment options available.