Delirium is a state represented by a group of symptoms rather than a disease. Delirium is signified by a temporary state of confusion and disorientation, with an unknown cause, a random onset over few hours or few days and fluctuating course. A typical delirium episode involves severe and sudden brain changes which lead a person to a state where thinking is unclear, attention is not focused and recent events cannot be remembered. It is commonly seen in ICU, Extensive care wards and patients been on sedation for a long periods. Delirium is often confused with dementia. However the two are distinguished on the basis of onset, cause, attention and fluctuations in symptoms visibility. A person with dementia may have delirium but a person with delirium episode may not necessarily have dementia.
The symptoms often fluctuate throughout the day, and there may be periods of no symptoms. And usually tend to be worse when in a dark and less familiar setting. A delirium episode has effect on all aspects of an individual.
An inability to stay focused on a topic or to switch topics, Getting stuck on an idea rather than responding to questions or conversation or being easily distracted by unimportant things and being withdrawn, are few symptoms eliciting reduced awareness of the environment.
Cognitive impairment is visible through Poor memory, particularly of recent events, Disorientation — for example, not knowing where you are or who you are, Difficulty in speaking with Rambling or nonsense speech and trouble understanding speech, Difficulty reading or writing.
Behavior changes includes hallucinations, Restlessness, agitation or combative behavior, Calling out, moaning or making other sounds, Being quiet and withdrawn ,Slowed movement or lethargy, Disturbed sleep habits, Reversal of night-day sleep-wake cycle.
Emotional disturbances such as Anxiety, fear or paranoia, Depression, Irritability or anger, euphoria, Apathy, Rapid and unpredictable mood shifts and Personality changes.
Delirium occurs when the normal sending and receiving of signals in the brain become impaired. This impairment is most likely caused by a combination of factors that make the brain vulnerable and trigger a malfunction in brain activity. The cause of Delirium can be attributed to a number of contributing factor such as infections, severe chronic illness, metabolic imbalance, medication, intoxication of alcohol or drugs and surgery. Sometimes it is a single cause, or a combination of causes and sometimes no cause can be identified.
The best preventive approach towards delirium is to target risk factors that might trigger an episode. Hospital should provide a conducive environment for frequent room changes, invasive procedures, loud noises, poor lighting, and lack of natural light and sleep to reduce confusion. strategies promoting good sleep habits, helping the person remain calm and well-oriented, and helping prevent medical problems or other complications — can help prevent or reduce the severity of delirium.