What is delirium and how can you help people suffering from it?

Delirium is a sudden and serious worsening of mental abilities. It happens quickly, usually over a period of hours or days, and it’s characterised by an alteration of consciousness, attention and cognitive function. It’s also known as sudden confusion.

Delirium is very common during hospitalisation, affecting around 2 in 10 patients, but it’s generally more common in older people, especially those in intensive care units.

Types of delirium

Healthcare professionals and experts have identified three distinct variations of delirium:

  • hyperactive delirium
  • mixed delirium
  • hypoactive delirium

People who have hyperactive delirium might seem restless, agitated and they may resist or respond aggressively to care. A person with hypoactive delirium, on the other hand, might be withdrawn, drowsy, unusually sleepy and they may find it hard to stay focused when they’re awake. Mixed delirium might present symptoms that correspond with both hypoactive and hyperactive delirium at different times, switching between symptoms over the course of a day, or from one day to the next.

What causes delirium?

There are a number of key factors that have been shown to contribute to delirium. These factors include high temperature, a urinary infection, or it may occur as a side effect to certain medications. The risk of delirium is significantly stronger with older patients and people who have had previous brain damage or disease. Here are the most common causes of delirium:

  • Drugs or alcohol
  • Dehydration
  • Infections
  • Medicines
  • Organ failure
  • Poisoning
  • Illness
  • Pain
  • Sleep deprivation
  • Metabolic disorders  

What are the symptoms of delirium?

Delirium occurs very suddenly, and it can manifest as distraction, lethargy, confusion or absentmindedness. Family, friends and caregivers are usually better placed to recognise and describe any changes in the mental ability of a loved one, mainly because they know the person best. A person with delirium might not be aware of any changes and will be unable to recognise when something is wrong.

The symptoms of hyperactive delirium are:

  • Restlessness
  • Rambling
  • Hallucinations
  • Anxiety
  • Disorientation
  • Trouble concentrating
  • Mood swings

The Symptoms of hypoactive delirium are:

  • Withdrawal
  • Lethargy
  • Drowsiness
  • Reduced motor activity

A person suffering with delirium might act like they’re intoxicated, and they may find it hard to pay attention. The symptoms of delirium usually get worse in the evening, which is known as sundowning.

Diagnosing delirium usually involves looking for issues with attention, memory, visual ability and memory. Patients may be asked to perform easy tasks like spelling a short word backwards or doing a basic mathematical equation.

How does infection cause delirium?

Although delirium isn’t a disease or infection, it can be triggered by an infection. Stressors like an infection, or inflammation, can cause acute changes in cognition. Infections such as pneumonia and sepsis can cause delirium, with urinary tract infections (UTIs) presenting as a common cause of delirium in elderly people, or people with dementia. A study conducted in 2017 found that delirium was linked to infection in around 60 elderly patients over a three-month period, with 73% suffering from sepsis.

How long does delirium usually last?

In 6 out of 10 people, the symptoms of delirium usually disappear within 8 days. Other people may experience symptoms for longer. For example, around 1 in 20 people, may still suffer with the symptoms of delirium more than a month after they first had symptoms.

What is the treatment for delirium?

Delirium usually goes away with treatment of the medical problem that caused it. For example, if a person is suffering from an infection, they can usually be given antibiotics to treat the infection, which will impact the delirium. If the delirium is caused by medication, doctors will review the drugs the patient is taking and stop any non-essential drugs that might be linked to delirium. If the cause is found and treated, delirium usually goes away.

How is delirium different from dementia?

Dementia is a general term that’s used to describe an impairment to a person’s ability to remember, think or make decisions. Alzheimer’s disease is the most common type of dementia, affecting memory, thinking and behaviour. While dementia develops over time, and has no known cure, delirium develops quickly, and the cause can usually be treated.

How can you help a person suffering with delirium?

There are lots of ways you can help a person suffering with delirium. Healthcare professionals, family members and friends can all help in the following ways:

  • Talk calmly, and in short, clear sentences
  • Reassure them as to where they are and who you are
  • Show them familiar photographs and objects from home
  • Set up a 24-hour clock and calendar that the patient can see
  • Help them eat and drink regularly
  • Help them develop a good sleep routine

How does the environment affect delirium?

Environmental factors have traditionally been considered as a factor in the genesis and management of delirium. There is no evidence to suggest that the environment alone can be the cause of delirium, but certain environmental conditions may exacerbate the symptoms. For example, a lack of natural light and lack of sleep can make confusion worse.

A study was conducted to investigate the effectiveness of environmental modifications on the symptoms of delirium. The study found that quiet-time protocols, earplugs, and bright light therapy showed a benefit for prevention or management of delirium.

Delirium is closely linked with sleep deprivation, especially in older patients. Multiple studies have concluded that the prevention or treatment of sleep deprivation may help to prevent or improve ICU delirium.

How can Sky Inside products help patients who are suffering from delirium?

Sky Inside products can make a huge difference to patients who are suffering from delirium. Digital windows and ceilings can reproduce natural scenery and help reduce levels of stress and anxiety, as well as offer a welcome distraction for patients. Patients who suffer with delirium will also benefit from natural lighting patterns that can help to maintain healthy sleeping patterns and circadian rhythms, which has been shown to prevent or improve the symptoms of delirium.

Contact us to find out more about how our medically validated products can benefit your patients when they’re suffering from the signs and symptoms of delirium.