​Delirium


Delirium is a disturbance in your mental capabilities that results in confused thinking and reduced awareness of your environment. The start of delirium is usually rapid, it occurs within a few hours or days. Delirium is usually temporary and reversible, and is most often caused by physical or mental illness. Disorders that may inhibit the supply of oxygen to the brain can cause delirium.
There are three main types of delirium.

  • Hyperactive delirium: this includes restlessness, agitation, rapid mood changes or hallucinations.

  • Hypoactive delirium: this includes inactivity or reduced motor activity, sluggishness, abnormal drowsiness or seeming to be in a daze.

  • Mixed delirium: this includes both hyperactive and hypoactive symptoms. You may quickly switch back and forth from one state to the other.

Common causes of delirium include:


Common symptoms of delirium include:

  • Changes in your level of alertness

  • Changes in feelings and perceptions

  • Changes in level of consciousness

  • Changes in movement or speed (such as slowed movement or lethargy)

  • Changes in sleeping patterns

  • Hallucinations

  • Rambling or nonsensical speech

  • Trouble understanding speech

  • Difficulty reading or writing

  • Feeling confused or disoriented about time or place

  • Problems in short-term memory

  • Disorganized thinking and behaviour

  • Sudden personality changes

  • Urinary Incontinence (that is, losing control over your bladder)

  • Problems in concentrating

If you or a loved one is facing symptoms of delirium, seek help from your doctor working with the Mind and Brain Service Line​ at The Aga Khan University Hospital. You can safely and privately discuss your symptoms, gain advice and receive personalized treatment and care.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.

Your doctor will diagnose delirium based on your medical history, tests to assess mental status and the identification of possible contributing factors. You will be asked about personal and family medical histories, including any history of mental illnesses. This information will help your doctor to decide on the best treatment. These tests will include:

  • Mental status assessment: your doctor will assess awareness, attention and thinking either informally (through conversation), or with tests that assess mental state, confusion, perception and memory.

  • Physical and neurological exams: your doctor will perform a physical exam, and check for signs of health problems or underlying disease. A neurological exam will also be conducted to check vision, balance, coordination and reflexes and determine if a stroke or another neurological disease is causing the delirium.

  • Other tests: blood and urine tests, as well as brain-imaging tests may be used when a diagnosis cannot be made with other available information.

When delirium is diagnosed, your doctor will first attempt to find and treat the underlying causes. He/she will carefully balance the fluid and nutrition you receive, as you may be unwilling or physically unable to maintain a balanced intake. If you are under alcohol withdrawal, treatment will include multivitamins, especially thiamine.

Your doctor and caregivers will ensure that you are kept in comfortable and familiar surroundings. Physical restraints will be avoided, even though sometimes, under the influence of delirium, you may attempt to get away and climb out of bed. Your doctor will ensure that a delirious patient is not left alone or unattended. The environment will be stable, quiet, and well-lit.

If you have trouble with vision or hearing, that will be corrected with eyeglasses or hearing aids.

Medications will only be used temporarily, in cases where your delirium is dangerous enough to harm others or you are not complying with treatment. Use of medication will be withdrawn as soon as the treatment is effective in curing your symptoms.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.




The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.