Delirium
Delirium is a sudden, fluctuating change in attention, awareness, and thinking caused by an underlying medical problem.
About delirium
Delirium is a sudden, fluctuating change in attention, awareness, and thinking caused by an underlying medical problem.
What can cause it?
Delirium is a rapid fluctuating brain dysfunction caused by infection, medicines, withdrawal, metabolic problems, pain, surgery, low oxygen, or organ failure.
Older adults and people with dementia are especially vulnerable.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Rapid onset of confusion
- Attention that comes and goes
- Agitation, unusual sleepiness, hallucinations, or reversed sleep pattern
How clinicians find the cause
Emergency evaluation confirms inattention and fluctuation while searching for the cause with medication review, examination, blood and urine tests, oxygen and glucose checks, and imaging when indicated.
Treatment and next steps
- 1
Treatment corrects the underlying illness and provides a calm safe environment.
- 2
Glasses, hearing aids, sleep-wake support, hydration, mobility, and familiar caregivers help recovery.
- 3
Sedating medicine is avoided when possible and reserved for immediate safety.
Supporting recovery
- Do not leave a delirious person alone or assume the change is normal aging.
- Bring medication lists and report the person's normal baseline.
What to expect
Delirium often improves when the underlying illness, medicine effect, withdrawal, or metabolic problem is corrected, but recovery can take days to weeks. Older adults and people with dementia or severe illness may recover more slowly and may not immediately return to their previous level of function.
Possible complications
- Falls, injury, pulling out medical devices, aspiration, or inability to eat and drink safely
- Longer hospitalization, loss of mobility or independence, and need for rehabilitation
- Persistent cognitive or functional decline, especially after severe illness or prolonged delirium
When to Contact a Medical Professional
This condition can be life-threatening. Call 911 or go to the nearest emergency department. Do not delay care to visit urgent care.
Sudden delirium needs emergency medical evaluation. Call 911 if the person is unsafe, difficult to wake, has weakness, trouble speaking, seizure, or breathing difficulty.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Medication review, hydration, mobility, sleep, orientation, and hearing or vision support reduce hospital risk.
- Treat infection and pain promptly.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.