The first goal of treatment for delirium is to address any underlying causes or triggers — by stopping use of a particular medication, for example, or treating an infection. Treatment then focuses on creating the best environment for healing the body and calming the brain.
Supportive care aims to prevent complications by protecting the airway, providing fluids and nutrition, assisting with movement, treating pain, addressing incontinence and keeping people with delirium oriented to their surroundings.
A number of simple, nondrug approaches may be of some help:
- Clocks and calendars to help a person stay oriented
- A calm, comfortable environment that includes familiar objects from home
- Regular verbal reminders of current location and what's happening
- Involvement of family members
- Avoidance of change in surroundings and caregivers
- Uninterrupted periods of sleep at night, with low levels of noise and minimal light
- Open blinds during the day to promote daytime alertness and a regular sleep-wake cycle
- Avoidance of physical restraints and bladder tubes
- Adequate nutrition and fluid
- Use of adequate light, music, massage and relaxation techniques to ease agitation
- Opportunities to get out of bed, walk and perform self-care activities
- Provision of eyeglasses, hearing aids and other adaptive equipment as needed
Talk with the doctor about avoiding or minimizing the use of drugs that may trigger delirium. However, certain drug treatment may calm a person who misinterprets the environment in a way that leads to severe paranoia, fear or hallucinations, and when severe agitation or confusion:
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- Prevents the performance of a necessary medical exam or treatment
- Endangers the person or threatens the safety of others
- Doesn't lessen with nondrug treatments
- Delirium. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed May 22, 2012.
- Dementia. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed May 22, 2012.
- Ghandour A, et al. Detecting and treating delirium - key interventions you may be missing. The Journal of Family Practice. 2011;60:726.
- Martinez FT, et al. Preventing delirium in an acute hospital using a non-pharmacological intervention. Age and Aging. 2012;0:1.
- Francis J, et al. Diagnosis of delirium and confusional states. http://www.uptodate.com/index.html. Accessed May 24, 2012.
- Tips and resources for caregivers: Caring for yourself when you are caring for others. Ask Medicare: Information to help you care for others. http://www.medicare.gov/caregivers/caregiver-topics-support.html. Accessed May 24, 2012.
- Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. June 28, 2012 & August 6, 2012.
- Philbrick KL (expert opinion). Mayo Clinic, Rochester, Minn. July 30, 2012.
- Sampson S (expert opinion). Mayo Clinic, Rochester, Minn. July 27, 2012.