Symptoms of delirium.

• Symptoms of delirium include rapid onset of confusion, inattention, disorganised thinking and altered level of consciousness.

• Difficulty focusing

• Easily distracted

• incoherent speech.

• Sometimes hyperactive and agitated or drowsy.

• Physical aggression, resistive behaviours with paranoid delusions.

• Agitation in a previously calm person, behaviours totally out of character or exaggerated pre-morbid personalities, so either a previously aggressive person will become more aggressive or placid and vice versa. 

• Visual hallucinations.

• One of the most common signs of delirium is sudden onset of drowsiness.  95% of drowsy patients after surgery have delirium.  Patients with post-operative delirium, with falls, slowing up and drowsy have the worst outcome.  These are usually the sickest patients with more complications.

• WARNING SIGNS OF DELIRIUM

  • Sudden onset of confusion.

  • Worsening confusion in someone with known dementia.

  • Not coping at home.

  • Behavioural or personality change.

  • Found on the floor.

  • Unexpected new falls.

  • Sudden deterioration in balance.

  • “Generally off” and not quite right.

  • New urinary or faecal incontinence.

• COMPLICATIONS OF DELIRIUM

  • Falls.

  • Dehydration.

  • Aspiration pneumonia from food or fluid going down the wrong way.

  • Malnutrition from poor dietary intake.

  • Pressure sores from prolonged immobility.

  • Infections

  • Urinary retention

  • Delirium itself is an increased risk factor for worsening underlying dementia.

  • Delirium is a strong risk factor for new onset dementia in the older patients. 

  • There is a much higher risk of having a fall and hip fracture with delirium in hospital,

  • Higher risk of ending up in a nursing home with delirium.

  • Delirium can last between 1 week to 4 weeks.  The longer it lasts the worse the outcome.

  • Delirium is a common reason for hospital Emergency Department presentation of older people.

  • Avoidable increased length of hospital stay.

  • Increase health care costs.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.