How Is Delirium Treated?

Delirium is a sudden change in a person’s mental state that happens over short periods of time. It can cause a person to have a hard time paying attention or following a conversation. Thinking and speech may be confused, illogical, unclear, and random. A person’s mental state may vary from being restless and alert to sluggish and sleepy.

How delirium causes harm

Delirium is a medical emergency. It has a big effect on the health of older adults. People with delirium tend to have a decline in their day-to-day living. They may also become unable to care for themselves. People with delirium often need to stay extra days in the hospital. They are also at higher risk for health problems, falls, and earlier death.

Studies have shown certain things about delirium, such as:

• It puts someone at higher risk of dying within 6 to 12 months

• It can cause faster mental decline in a person with dementia

• People in the hospital who have delirium are more likely to have long-term mental health problems

• An episode of delirium greatly increases risk of dementia in a person without dementia. It may also be the first sign of dementia.

• An episode of delirium can make a person’s dementia more severe

• An episode of delirium can make a person more likely to live in a long-term care facility

• It can cause families financial strain due to high healthcare costs 

Finding the cause

Delirium is treated by finding and treating the underlying cause. It has many possible causes, such as reaction to medications, changes in blood chemistry, infections, strokes, and acute heart diseases.

Health care providers will take a complete medical history and perform a physical exam. They may do tests to find the cause of a person’s delirium. The tests may include:

• Asking questions.

• A physical exam. This will check the general health of the person.

• Blood and urine tests, as indicated.

• Imaging tests. These may include a CT scan or MRI of the head. These check for problems in the brain such as bleeding, infection, or a tumor.   

Common treatments for delirium

Once a cause is found, steps are taken to treat the underlying problem. In many cases, the delirium may resolve. 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 unnecessary IV tubes, restraints, and catheters is often helpful. Psychoactive medicines should be reduced or removed. In rare cases, certain medicines may be given to a person who is severely agitated. Having family members help with care is encouraged, as 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.

If you think that your loved one may have delirium, seek help from a healthcare provider right away. Or call 911 or your local emergency number.