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KEY POINTS
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Delirium is a sudden loss of attention, change in orientation, lack of awareness, and inability to think clearly. Delirium may develop in a matter of hours or over several days. Sometimes delirium is called an altered mental status.
Delirium is a symptom of another problem. It may be caused by something that changes chemicals in the brain or changes the way the brain uses oxygen. It may be caused by medicine you are taking or by a medical problem.
Delirium caused by medicines can be a particular problem for older adults, who may be taking several different drugs. Also, as you get older, your body may not process drugs well. As a result, drugs can stay too long in the body and cause more side effects.
Examples of medical problems that can lead to delirium include:
Alcohol use and withdrawal from alcohol can cause delirium.
If you are in the hospital for several days or are very ill, you have a greater risk for delirium. This is especially true if you are in the critical care unit or intensive care unit (ICU). You may not be able to sleep, and there may be no windows and no day and night routines to help keep you oriented.
The key symptoms are confusion and disorientation. Confusion means that you are not thinking clearly. Disorientation means not knowing the time, date, where you are, who you are, or who the people around you are. Other symptoms may include:
If you are panicked, upset, and agitated but you know who you are, where you are, and what is going on around you, you do not have delirium.
Symptoms may be severe, and they may come and go. They may be worse at the end of the day. They may last days or weeks depending on the cause.
Your healthcare provider will ask about your symptoms and medical history, including medicines you are taking. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to check for possible causes of the symptoms.
You may have tests such as:
Your provider may also ask some questions to test memory and thinking and to check for depression. Key questions to test for confusion are:
Your provider may check with family, friends, and hospital staff to see if things said by you are true or imagined.
If someone has new or worse symptoms of delirium, seek medical help. Don’t leave a delirious person alone.
Treatment depends on what is causing the delirium. For example, changing medicines or treating a medical problem may take care of the problem.
Treatment may also include:
Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.