Jacob Parker

Recent studies have shown that most patients of delirium would die from it if not

recognized early (Institute for Aging Research). Delirium is commonly found in older adults. It is

sometimes reversible, but it known for an increasing number of deaths, increasing cost of

treatment, and long-term damage to thinking and moving processes (Tullmann). This disorder is

a temporary state of mental confusion resulting from high fever, intoxication, shock, or other

causes, and is characterized by anxiety, disorientation, memory impairment, hallucinations,

trembling, and incoherent speech (Delirium. American Heritage.). Delirium, which slows

down thinking and moving processes, was once thought to only come from depression, has now

been known to have several causes, and is now reversible through detailed treatments.

There are four classes of delirium. These are known as normal, hypoactive, hyperactive,

and mixed delirium. Normal delirium is caused by the basic risk factors and causes of delirium.

Hypoactive delirium is a much more severe case of delirium, which involves the patient’s level

of movement and when they may not be responding. This is the most life endangering class of

delirium and it is also known as delirium tremens. (Institute for Aging Research). Hypoactive

delirium my be confused with depression or dementia. These patients could go unrecognized for

their case of delirium. (Gleason). Hyperactive delirium symptoms range from a slight restless

behavior to constant movement and agitation. These patients can be agitated, disoriented, and

delusional. They could also have hallucinations. Mixed delirium shows symptoms of both

hyperactive and hypoactive delirium. All of these types of delirium could be mistaken for other

psychotic disorders. (Institute for Aging Research).

Delirium is usually caused by more than one risk factor. Old age, dementia, sickness,

medication, alcohol abuse, depression, pain, and sensory damage are several of the known risk

factors (Tullmann). Causes of delirium are drug abuse, infections like pneumonia, poisons, and
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changes in acid and base levels. Several disorders that could help cause delirium include: heart

failure, decreased oxygen, thyroid disorders, anemia, nutritional disorders, infections, kidney

failure, and liver failure (Jasmin). Cancer has also been known to cause this disorder (Cognitive

Disorders and Delirium.). Most cases of delirium happen after something that causes brain

function to have problems. These disturbances by one, or a combination of several, serious

medical issues (Delirium. Rush-Presbyterian-St. Luke’s Medical Center: Medical

Encyclopedia). More severe cases of delirium, such as delirium tremens, can happen from

drinking large amounts of alcohol. The risk is even higher when the drinker doesn’t eat enough.

This may also happen from head injuries, infection, or sickness from a past of alcohol abuse

(Dugdale).

Delirium is a mental disorder, but not a disease. People who are delirious may seem a

little out of it and aren’t normal. They could show changes in level of consciousness, have

trouble speaking, and have problems understanding things (Buckles). Symptoms of delirium

include: changes in how alert the patient is, how the patient feels about things, a change in their

level of focus, movement speed, and sleep and resting patterns (Jasmin). Emotional and

personality changes are two other symptoms. Some of these changes include: anger, anxiety,

apathy, depression, euphoria, and irritability. A delirious person could have disorganized

thinking. They could speak without making sense, or have other problems concerning speech

control. Patients my have disrupted or wandering attention. They could not have ability to think

or behave like they usually would, or they could just have problems with concentrating. Some

people may have a decrease in short-term memory. They may not be able to remember past

events, especially before their delirium began (Zieve). Chest pain, fever, and stomach pain are

some additional symptoms that could happen. Symptoms of delirium tremens include: body
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tremors, mental status changes, seizures, and alcohol withdrawal. Symptoms show up anywhere

after seventy-two hours of the last drink and may last up to ten days.

Treatment may require the patient to stay in the hospital for a little bit of time and is

required for more serious cases of delirium (Jasmin). Treatment for delirium includes:

minimizing risk factors and creating a therapeutic environment. To minimize risk factors, the

care provider should avoid high-risk medications, prevent or treat infections, provide a good

amount of pain control, and give the patient as much oxygen as needed (Tullmann). Delirium can

also be treated by sedatives and tranquilizers (Delirium. Rush-Presbyterian-St. Luke’s

Medical Center: Medical Encyclopedia.). There are several tests that can be used to test

for delirium. Doctors can test B12 levels, ammonia levels, drug or alcohol levels, liver function,

and mental status along with many others. Some tests may have results that aren’t normal. A

nervous system exam, psychologic studies, and tests for feeling, thinking, and movement are

some tests that fall into this category (Jasmin). If treatment is unsuccessful, delirium can cause

death, long-term damage of thinking processes, problems from operation, decreased functional

ability, increased hospital time, institutionalization, and an increased cost of health care

(Tullmann).

Even though delirium has many causes and symptoms, it could still go unrecognized.

This is also troubled by the four classes which could cause some extra confusion. The future still

looks promising as doctors and medical researchers continue to find ways to treat delirium.

Puchta said, “If you notice any change in a loved one’s behavior, regardless if it is sudden or

gradual, seek medical attention, so that you may treat their medical condition and improve their

quality of life.” This is very important when trying to recognize delirium instead of waiting for

the doctors to find it. John Buckles said, “People often make statements, such as, ‘Dad’s going
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nuts’ or ‘Mom’s lost her mind,’ and don’t recognize the treatments that might be available to help

a loved one.”