Diagnosis
A delirium diagnosis is based on recent medical history and physical and mental tests. An exam may include:
- Recent medical history. This typically includes asking questions about a person's recent health and any changes in the past day or two. Has there been a recent infection? Did the person begin a new medicine? Was there an injury or new pain, such as chest pain? Were there any headaches or weakness? Did the person use alcohol or drugs?
- Review of mental status. This involves checking awareness, attention and thinking. It may be done by a healthcare professional having a conversation with the person. Or it may be done with tests. Information from family members or caregivers can be helpful, especially about any recent changes in awareness or alertness.
- Physical and neurological exams. A physical exam checks for signs of health issues. A neurological exam checks vision, balance, coordination and reflexes. This can help a healthcare professional see if a stroke or another disease is causing delirium.
- Other tests. Blood, urine and other tests may be helpful. Brain-imaging tests may be used when a diagnosis can't be made with other information.
Treatment
Treating delirium first involves addressing anything that could have caused delirium. That may include stopping some medicines, treating an infection or treating a lack of nutrients in the body. After that, treatment of delirium focuses on creating the best setting for healing the body and calming the brain. That may include a range of measures.
Supportive care
The goal of supportive care is to prevent a person from developing other health issues as a result of delirium. To do that, the healthcare team likely will take the following steps:
- Provide fluids and nutrition.
- Assist with movement.
- Treat pain.
- Make sure the person can breathe easily.
- Address any issues with bladder control.
- Treat constipation.
- Avoid using IV lines or bladder tubes if possible.
- Avoid changes in surroundings and caregivers when possible.
- Include family members or other familiar people in care.
Medicine
If you're a family member or caregiver of someone who has delirium, talk with a member of the healthcare team about medicines that may trigger symptoms. The person with delirium may need to stop taking those medicines or take them at a lower dose.
Sometimes pain may cause delirium. In those situations, medicine may be prescribed to manage pain. Other medicines may help calm a person who is agitated or confused. Or medicines may be needed if the person is showing distrust of others, is fearful or is seeing things that others don't see. These medicines may be needed when symptoms:
- Make it hard to do a medical exam or provide treatment.
- Put the person in danger or threaten the safety of others.
- Don't lessen with other treatments.
When symptoms go away, the medicines are usually stopped or are given in lower doses.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Coping and support
If you're a family member or caregiver of someone who is at risk of delirium, you can take steps to help prevent an episode of delirium. If you take care of someone who is recovering from delirium, these steps also can help improve the person's health and prevent another episode.
Encourage good sleep habits
To help get a good night's sleep:
- Provide a calm, quiet setting for sleep.
- Use lighting that reflects the time of day.
- Help the person keep a regular daytime schedule.
- Encourage self-care and activity during the day.
Foster calmness and awareness
To help the person remain calm and aware of the surroundings:
- Provide a clock and calendar, and use them during the day.
- Communicate simply about any change in activity, such as time for lunch or time for bed.
- Keep familiar and favorite objects and pictures around, but avoid a cluttered space.
- Approach the person calmly.
- Identify yourself or other people.
- Avoid arguments.
- Use comfort measures, such as touch, if they help.
- Lower noise levels and other distractions.
- Make sure the person has eyeglasses and hearing aids if needed.
Prevent health concerns
To help prevent medical issues:
- Give medicines on schedule.
- Provide plenty of fluids and a healthy diet.
- Encourage regular physical activity.
- Get prompt treatment for possible health concerns, such as an infection.
Caring for the caregiver
Caring for a person with delirium can be hard and exhausting. Take care of yourself too.
- Consider joining a support group for caregivers.
- Learn more about the condition.
- Ask for pamphlets or other resources from the healthcare team, nonprofit organizations or community health services.
- Share caregiving with family, friends or other people who are familiar to the person so you get a break.
Preparing for your appointment
If you're a family member or primary caregiver of a person with delirium, you'll likely play a role in making an appointment or giving information to the healthcare team. Here's some information to help you get ready for the appointment and know what to expect.
What you can do
Before the appointment, make a list of:
- All medicines the person takes. That includes all prescriptions, medicines available without a prescription and supplements. Include the doses and note any recent medicine changes.
- Names and contact information of any person who provides care for the person with delirium.
- Symptoms and when they started. Describe all symptoms and any changes in behavior that began before the delirium symptoms. These might include pain, fever or coughing.
- Questions you want to ask the healthcare professional.
What to expect from the doctor
A healthcare professional is likely to ask questions about the person with delirium. The questions may include:
- What are the symptoms and when did they begin?
- Has there been a recent fever, cough or urinary tract infection or any sign of pain?
- Was there a recent head injury or other trauma?
- What were the person's memory and other thinking skills like before the symptoms started?
- How well did the person perform everyday activities before symptoms started?
- Can the person usually function independently?
- What other medical conditions have been diagnosed?
- Are prescription medicines taken as directed? When did the person take the most recent dose of each?
- Are there any new medicines or supplements?
- Do you know if the person recently used drugs or alcohol? Does the person have a history of problematic alcohol or drug use? Is there any change in the pattern of use, such as increasing or stopping use?
- Has the person recently seemed depressed, very sad or withdrawn?
- Has the person shown signs of not feeling safe?
- Has the person recently seemed distrustful, suspicious or afraid of other people?
- Has the person seen or heard things that no one else does?
- Are there any new physical symptoms, such as chest or stomach pain?