Sunday, December 4, 2011

Is Delirium Reversible?

I would like to highlight Delirium because it is an illness of particularly high occurrence in the senior population.

As a body ages, its ability to maintain ‘equilibrium’ when under physical or psychological stress can become compromised. Even minor changes that once were easily tolerated, (taking a medication for pain for example, or minor dehydration) may no longer be.


A toxicity or an infection develops in the body that may rapidly result a medical emergency. Delirium is so serious because of its rapid onset. Within hours, a senior who is living independently at home with no evidence of illness can become debilitated and disoriented in the extreme. A person experiencing a Delirium may even appear as if they have dementia to those who do not know them.

Major signs of a delirium are the fluctuations of alertness and orientation throughout the day. In one encounter with the person they may seem coherent and then in the next they may not know where they are or what year it is.


They may be awake all night restless and agitated and sleeping during the day (Day/Night reversal) and may experience visual or auditory hallucinations. The most common reasons a person may succumb to delirium are related to ‘Drugs’ or ‘Bugs’.

‘Drugs’: The addition of one or more new medications or a regularly used medication that accumulates in the body to a high level.


‘Bugs’: infections in the body - frequently these are urinary tract infections or pneumonia.

Treatment for Delirium

Delirium is a Medical emergency that is often under recognized and under treated. If left untreated, Delirium can lead to death. It is an acute illness that creates tremendous vulnerability in seniors if there is no family member or friend to advocate and explain that the behaviour exhibited is not ‘normal’ for them.

The great news, however, is that it responds to treatment often restoring the person to health quickly if treated promptly. To treat a Delirium, the underlying cause (the reason for the delirium) needs to be treated. Diagnosing and treating an infection or stopping any offending medications causing toxicity and rehydrating the body can put the person back on the road to recovery.

My advice to a senior in terms of prevention: Care for your body by remaining hydrated (drink at least one litre of non-caffeinated fluid each day) so that dangerous levels of your medications do not build up in your system and you do not put yourself at risk for infections.

This article has been provided by Laurie Duke, RN, CPCA. Laurie is a registered nurse who has worked in the field of geriatric psychiatry since 1993. 

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