Delirium

This type of confusion is frequently seen in older patients or those who are suffering from a serious illness like cancer. It can also appear in people taking certain medication or abusing substances like street drugs or alcohol. In some cases, recognizing and dealing with the underlying cause will reverse the confusion. In other situations, the symptoms of this disorder may be more challenging to treat effectively.

Types of Delirium

• Hyperactive - This state is characterized by irritability and agitation. The patient may experience hallucinations or rapid, loud speech.

• Hypoactive - In contrast to hyperactive delirium, hypoactive is a state of reduced activity, lethargy, and apathy. Patients with hypoactive usually exhibit very little movement or speech.

• Mixed - This condition combines the two types of above, so the patient will alternate between agitation and reduced activity.

Symptoms of Delirium
There are a number of symptoms that may accompany this disorder. These include:

• Confusion that may come and go
• Speech that is difficult to understand or incoherent
• Hallucinations; both auditory and visual
• Disorientation as to time and place
• Disruption to sleeping and waking patterns
• Intense emotions like anger, irritability or fear

These symptoms will often come on rather suddenly, and are somewhat common in elderly patients in a hospital setting. Unfortunately, the symptoms are sometimes mistaken for dementia or simply a sign of advanced age, delaying diagnostic tests and treatment.

Treatment Options
Most treatment for this disorder revolves around addressing the underlying issues and providing an environment that is calm and conducive to improved brain function. Medication is rarely used for treatment; in fact, some medications can even be the cause of the symptoms.

If an underlying cause can be pinpointed, such as substance abuse, illness or infection, treatment involves addressing the specific cause. If the cause can be eliminated, the symptoms of this disorder can often be reversed.

If a cause cannot be found, treatment usually involves providing a calm environment that allows the brain to return to normal functioning on its own. This may include a familiar setting, reminders about time of day and place, natural light during the day and uninterrupted sleep at night.

Because the patient often cannot voice his needs in this state, it is important for family members to get involved with the medical staff to create as comfortable a setting as possible. Some patients will also respond well to relaxation techniques like massage and quiet music.

The earlier confusion is identified and treated, the better the prognosis for the patient. Family members who have elderly patients in the hospital should remain alert to the symptoms of this disorder and notify hospital staff if changes to speech, movement or behavior occur.

Delirium is a disturbing state that can cause concern for the patient and family members alike. The good news is that many cases of this type of confusion can be effectively reversed by identifying and eliminating the underlying cause and providing a safe, comfortable environment for the patient.

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