What is Delirium?
What is Delirium? Delirium is a serious mental disorder that causes the patient to experience severe confusion and loss of awareness of the surrounding environment. In the early phase, delirium will develop quite rapidly, from several hours to several days.
Some factors that increase a person’s risk of delirium are:
- Have a brain disorder.
- Never had delirium before.
- Having vision or hearing impairment.
- Suffered from several medical disorders.
Delirium recovery depends on their physical and mental health conditions before developing delirium. Patients with delirium who have serious illness are at risk for experiencing some of the following complications:
- The general decline in health.
- Poor recovery after surgical procedure.
- Increased risk of death.
- Loss of ability to interact.
- Loss of ability to care for oneself.
Symptoms and Type of Delirium
Symptoms are something that is felt and told by the patient. Patients will show symptoms after he was exposed to delirium several hours to several days. Sometimes, delirium symptoms will worsen at night.
Some of the common symptoms of delirium are:
- Reduced awareness of the surrounding environment. This can cause the inability to stay focused on the topic or to change the subject, easily distracted by unimportant things, and daydreaming so as not to react to the things happening around them.
- Poor thinking ability (cognitive impairment). This will look like bad short-term memory, disorientation (not knowing where he is), difficulty speaking, talking long-winded, and difficulty in understanding speech, reading and writing.
- Emotional Disorder. Patients will appear restless, fearful or paranoid, depressed, irritable, apathetic, sudden mood changes, and personality changes.
Changes in behavior. Other people will see delirium sufferers hallucinating, agitating and aggressive, making a groaning or calling voice, being quiet and closing, slowing movement, and disruption of sleeping habits (active hours and hours of sleep being reversed).
Based on the symptoms indicated by the patient, delirium can be divided into several types, namely:
- Delirium is hyperactive. Patients will look restless, often moody or hallucinating.
- Delirium is hypoactive. Patients will appear inactive or reduce motion activity, lethargy, drowsiness is not normal, or look confused.
- Delirium blend. Patients will often show symptoms change from hyperactive delirium to hypoactive delirium or vice versa.
Cause of Delirium
Delirium can be caused by one or more factors. Some of the factors that may cause delirium are:
- Some types of medication or drug toxicity.
- Chronic or severe illness.
- Misuse of drugs and alcoholic beverages.
- Drug dropouts or discontinuation of alcoholic beverages.
- Malnutrition or dehydration.
- Certain medical conditions.
- Sleep disturbance or severe emotional disturbance.
- Metabolic imbalances.
- Fever and acute infection, especially in children.
- Exposed to toxins.
- Surgical process or other medical procedures involving anesthesia.
Some medications or combinations of drugs may also trigger the appearance of delirium, namely:
- Pain relief medication.
- Parkinson’s disease.
- Sleeping pills.
- Asthma medication.
- Anti-allergic medicine.
- Drug for convulsions.
- Medications for mood disorders, such as depression and anxiety.
Diagnosis of Delirium
Diagnosis is a doctor’s step to identify a disease or condition that explains the symptoms and signs experienced by the patient. There are several checks that the doctor will do to diagnose delirium, namely:
- Examination of physical and neurological conditions. Patients will undergo a physical examination to check for medical disorders or diseases that can cause delirium. On neurological examination, the doctor will look for other neurological diseases or strokes that can underlie delirium through examination of vision conditions, balance, coordination, and reflexes.
- Examination of psychiatric conditions. Doctors will assess the level of awareness, attention, and thinking of the patient through interview, testing and screening sessions.
Other checks. Your doctor may advise patients to undergo blood, urine, and brain or chest imaging tests.
Treatment and Prevention of Delirium
The first goal of treatment is to deal with the underlying cause of delirium. After that, treatment therapy will aim to create an environment suitable for healing the body and calm the mind of the patient.
Doctors will try to reduce or avoid the use of drugs that can trigger delirium. However, doctors still prescribe some drugs that work to control the pain that can trigger delirium.
Supportive care is also needed for delirium sufferers to prevent complications. Some treatment supporters of delirium sufferers are:
- Protect the airway.
- Provide fluids and nutrients needed by the patient’s body.
- Helping people with difficulty moving the body.
- Handle the pain experienced by the patient.
- Prevent the sufferer from losing control over himself.
- Avoid the use of physical restraint or use of bladder tubes.
- Avoid many changes in the environment around the patient.
- Encourage interaction between patient with family or close relatives.
Some things that can be done to prevent or not aggravate delirium, namely:
- Avoiding factors at risk of triggering delirium, such as being in a hospital with a new atmosphere, noise, drug use, room lighting or bad room, confusion.
- Perform healthy sleeping habits. Providing quiet rooms and surroundings, good lighting, including helping people with balanced activities during the day, can help them sleep better at night.
- Keep trying to calm or direct the patient so as not to feel many changes around him. This includes putting things known to the people around them, providing hours and calendars, and trying to speak in a low voice so that the patient is not disturbed.
- Avoid medical problems and other complications, which also helps to reduce the severity of delirium. A healthy diet, medication is available, suggestions for exercise, and treating the physical condition that lead to certain health disorders, all can help reduce delirium recurrence.