Deliriuim

Definition:

An acute or sudden onset of mental confusion as a result of a medical, social and/or environmental condition.

Thought Process:

Fluctuates between rational state and disorganized, distorted thinking with incoherent speech.

Memory Impairment:

Recent and immediate memory impaired

Effects on Sleep-wake Cycle

Disturbed. Sleep-wake cycle is reversed (up in night, very sleepy and sometimes non-responsive during the day)

Hallucinations and delusions:

 Often of a frightening or paranoid nature

Diagnosis:

Diagnosis based on rapid onset of fluctuating symptoms. Can be mistaken for progression of the dementia.

Care Approaches:

Early recognition is key. Keep person safe, find cause of the delirium and treat as quickly as possible.

Prognosis:

Treatable and reversible with early diagnosis but can lead to permanent disability or death.

Treatment:

Treat underlying cause. Monitor response. Be alert for relapse, occurs in 90% of causes

 

Forman, MD and Zane, D. 1996. Nursing strategies for acute confusion in elders. American Journal of Nursing. 96 (4) 44-51.

Lipowski, Z. 1989. Delirium in the elderly Patient. The New England Journal of Medicine. 320 (9) 578-582.

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