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 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.


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


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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