Avera Behavioral Management

The Resident with Delirium

Delirium is biologically based syndrome characterized by a rapid onset, a fluctuating course and global cognitive impairment.
Delirium is produced when one or more biological factors stress brain function to the point where decompensation occurs.
If a resident's behavior and/or cognitive status undergo a sudden change, consider delirium after eliminating obvious physiological factors such as pain, thirst, or hunger.
Demented individuals are particularly vulnerable to delirium. Any sudden deterioration in a demented resident may represent a delirium superimposed on dementia.
If the biological factors underlying the delirium can be corrected, recovery from the delirium is usually rapid and complete, although some symptoms may linger for months, especially in the elderly.
As medications are so often implicated in delirium, all nonessential medications should be discontinued, especially in the absence of other etiological possibilities.
Delirious residents are often very frightened. They should be approached in a calm, reassuring manner and cared for in a restful, familiar environment.
Psychoactive drugs may be required to manage the disruptive and violent behavior that sometimes occurs.
Transfer to a general hospital may have to be considered.