I have altered and change the write up for my convenient reference.
Delirium
Overview
Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment.
The start of delirium is usually rapid. – this really shock me, because I was focus, discipline and patient for so long, and suddenly, so fast and so unexpectedly, I was doing what I normally do not do,
What is Delirium?
Delirium is a medical word used to describe the condition that causes an unwell person to become confused in his thinking. This is a physical problem, not a psychological one.
What Causes Delirium?
• A physical illness etc flu, fever, encezma, high blood pressure
• Changes in the chemistry of the blood
• Metabolic imbalances
• Dehydration
• Sleep deprivation
• severe emotional distress
• Alcohol or drug abuse or withdrawal
Anyone can become delirious under certain circumstances of illness.
What Are My Signs and Symptoms of Delirium?
I had these symptoms of delirium:
• Being restless and unable to stay still;
• I could not sleep and climb out of bed
• Having restless spells that alternate with being tiredness and exhaustion.
• Changes in alertness
• Changes in feeling (sensation) and perception
• Changes in level of consciousness or awareness of my surrounding
• Changes in movement (for example, may be slow moving or hyperactive)
• Confusion (disorientation)
• Disorganized thinking – I will do things that I would not normally do
• Emotional or personality changes, such as at work, I was irritable and angry. I can even be paranoid and suspicious
• Movements triggered by changes in the nervous system
• Problem concentration
This experience felt like a nightmare or dream but all these happen while I am awake.
Reduced awareness of the environment
This may result in:
• An inability to stay focused on a topic or to switch topics
• Getting stuck on an idea rather than changing plan
• Being easily distracted by unimportant things
• Being withdrawn, with little or no activity or little response to the environment
Poor thinking skills (cognitive impairment)
This may appear as:
• Poor memory, particularly of recent events
• Disorientation, for example, not knowing who you are
Behavior changes
This may include:
• Restlessness, agitation or combative behavior
• Calling out, moaning or making other sounds
• Being quiet and withdrawn — especially in older adults
• Slowed movement or lethargy
• Disturbed sleep habits
• Reversal of night-day sleep-wake cycle
Emotional disturbances
This may appear as:
• Anxiety, fear or paranoia
• Depression
• Irritability or anger
• A sense of feeling elated (euphoria)
• Apathy
• Rapid and unpredictable mood shifts
• Personality changes
Types of delirium
Experts have identified three types of delirium:
• Hyperactive delirium. Probably the most easily recognized type, this may include restlessness (for example, pacing), agitation, rapid mood changes or hallucinations.
• Hypoactive delirium. This may include inactivity or reduced motor activity, sluggishness, abnormal drowsiness or seeming to be in a daze.
• Mixed delirium. This includes both hyperactive and hypoactive symptoms. The person may quickly switch back and forth from hyperactive to hypoactive states.
Delirium and dementia
Dementia and delirium may be particularly difficult to distinguish, and a person may have both. In fact, frequently delirium occurs in people with dementia.
Dementia is the progressive decline of memory and other thinking skills due to the gradual dysfunction and loss of brain cells. The most common cause of dementia is Alzheimer’s disease.
Some differences between the symptoms of delirium and dementia include:
• Onset. The onset of delirium occurs within a short time, while dementia usually begins with relatively minor symptoms that gradually worsen over time.
• Attention. The ability to stay focused or maintain attention is significantly impaired with delirium. A person in the early stages of dementia remains generally alert.
• Fluctuation. The appearance of delirium symptoms can fluctuate significantly and frequently throughout the day. While people with dementia have better and worse times of day, their memory and thinking skills stay at a fairly constant level during the course of a day.
Delirium occurs when the normal sending and receiving of signals in the brain become impaired.
This impairment is most likely caused by a combination of factors that make the brain vulnerable and trigger a malfunction in brain activity.
Prevention
The most successful approach to preventing delirium is to:
• target risk factors that might trigger an episode.
• promoting good sleep habits, helping the person remain calm and well-oriented,
• prevent medical problems or other complications — can help prevent or reduce the severity of delirium.
• Other types of drugs may help calm a person who misinterprets the environment in a way that leads to severe paranoia, fear or hallucinations, and when severe agitation or confusion occurs.
Promote good sleep habits
To promote good sleep habits:
• Provide a calm, quiet environment
• Keep inside lighting appropriate for the time of day
• Plan for uninterrupted periods of sleep at night
Promote calmness and orientation
To help the person remain calm and well-oriented:
• Provide a clock and calendar and refer to them regularly throughout the day
• Keep familiar and favorite objects and pictures around, but avoid a cluttered environment
• Avoid arguments
• Use comfort measures, such as reassuring touch, when appropriate
• Keep noise levels and other distractions to a minimum
• Provide and maintain eyeglasses and hearing aids
Prevent complicating problems
Help prevent medical problems by:
• Giving the person the proper medication on a regular schedule
• Providing plenty of fluids and a healthy diet
• Encouraging regular physical activity
• Getting treatment for potential problems, such as infection or metabolic imbalances, early
What to expect from the doctor
The doctor is likely to ask a number of questions.
These are questions that I can relate to:
• What are the symptoms and when did they begin?
• Is there or was there a recent fever, cough or urinary tract infection?
• 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 the onset of symptoms?
• Can he or she usually function independently?
• What other medical conditions have been diagnosed?
• Do you know if the person recently used drugs or alcohol? Does the person have a history of alcohol or drug abuse? Is there any change in the pattern of use, such as increasing or stopping use?
• Has the person recently appeared depressed, extremely sad or withdrawn?
• Has the person indicated that he or she does not feel safe?
• Are there any signs of paranoia?
• Are there any new physical symptoms?
