Delirium Geriatrics “My mother’s mind was fine when she was warded after a fall. Then she became confused and started seeing things. We were so worried we told the doctor. He found out that she had an infection and started her on treatment. She soon returned to normal which was a huge relief.” What is it? Delirium is a sudden change in the brain that causes confusion and distress. It comes on over a few hours or days and usually stops once the cause is treated. Who does it affect? Delirium is a common condition, appearing in 10 to 20% of medical inpatients. The prevalence increases with age and amongst patients with dementia.
What are the symptoms? • Confusion • Poor attention • Mixed up speech • Not recognising items or being unable to learn new information • Not knowing where you are • Hearing or seeing things (hallucinations) • Getting upset or angry easily • Shouting, screaming or cursing • Not sleeping properly • Pulling at clothing or bedding or not moving hands What causes it? • Infection • Medications • Constipation • Urine retention • Pain • Left over pain relief from surgery before it wears off • Heart attack • Being in an unfamiliar place • Alcohol poisoning or withdrawal • Minerals in the blood being out of balance
How do I handle someone with delirium? • Speak slowly and clearly in a normal, non-threatening voice • Identify yourself, even if you are a family member • Reassure them • Maintain eye contact • Appear interested in what they are saying • Do not make sudden movements • Explain what you are going to do before you do it • Gently correct their mistakes but do not argue with them • Try to re-orientate them/ remind them where they are When should I tell a doctor or nurse? Tell a doctor or nurse if you notice any sudden change in your loved one’s mood or behaviour or if something does not seem normal.
What can I do to help? • Put up a clock, calendar and signs to help them orientate themselves • Have someone they know with them every day • Encourage them to walk around if it is safe for them to do so • Check that they have pain control medication, if needed • Do not self medicate • Check that they are using their hearing aids and spectacles • Encourage them to pass urine and open their bowels regularly to prevent urine retention and constipation • Set up a day and night routine so they are active during the day and sleep at night • Help them with meals and drinks so they take enough food and fluids • Protect them from other problems such as falls and pressure sores
Yishun Health Campus is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
IP.PE.22.0717