Download Department of Medicine for the Elderly Delirium Patient and Carer

Department of Medicine for the Elderly
Delirium
Patient and Carer Information leaflet
September 2011
To provide High Quality Healthcare to be proud of .
This leaflet has been produced to give you general information about
your condition. Most of your questions should have been answered by
this leaflet. It is not intended to replace the discussion between you and
your doctor, but may act as a starting point for discussion. If after
reading it you have any concerns or require further explanation, please
discuss this with a member of the healthcare team who has been caring
for you.
What is Delirium?
Delirium is a sudden change in mental state, which may be confusion,
agitation, personality change, and difficulties with understanding and memory.
There are a number of causes, such as a medical illness or after surgery. It
can start within hours, and usually improves as the condition causing it
improves. It is not the same as dementia, although people with dementia are
at increased risk of delirium.
How common is it?
About 1 in 10 people in hospital have a period of acute confusion. This may
be more frequent in those who are older, have memory problems or dementia,
have poor eyesight or hearing, have a terminal illness or have a medical
condition affecting the brain, such as a stroke, head injury or infection.
What is it like?
It can be frightening for both the person affected as well as those visiting and
caring for them. They may be less aware of their surroundings, time and
people.
People with delirium may:
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Find it difficult to follow a conversation and maybe be easily distracted.
Have vivid dreams or hallucinations, which may also be frightening and
upsetting.
Become agitated and paranoid and need a lot of reassurance.
Become sleepy and slow, and may appear withdrawn.
Be confused at some times more than others, especially at night.
Please notify a member of staff if you notice a change in your relative’s or
friend’s behaviour.
What causes it?
There may be more than one cause, although sometimes no cause is found.
Common causes include:
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Any infection
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Pain
Medications, including pain killers
Dehydration and other chemical problems within the body
Being in a new and unfamiliar place
Major surgery
Brain problems, including stroke and seizures
Terminal Illness
Suddenly stopping some drugs, alcohol or cigarettes
How is it treated?
If someone becomes suddenly confused they need to see a doctor as soon as
possible. The person may not understand what is happening, so it is helpful if
someone who knows them can stay with them and give information to the
medical and nursing teams.
Treating the underlying cause treats the confusion. This includes treating
infections, pain and constipation.
Special nursing techniques are also used to minimise disorientation and
confusion.
Sedatives can make the confusion worse and should only be used in certain
situations, such as:
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For an essential investigation or treatment
To prevent the person harming themselves or others
They will be used for as short a time as possible.
How can relatives and friends help?
Whilst it can be frightening and upsetting for you to see your loved one
confused and agitated it is important you stay calm.
You can:
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Reassure them.
Talk in short, simple sentences, checking you have been understood.
You may need to repeat things. Talk about familiar topics.
Gently remind them where they are, the date and time, what they are
doing in hospital.
Bring in their own calendar or small clock.
Bring in their glasses and hearing aids.
If required, help them to eat and drink
Visit in small groups, particularly in the evening as confusion is often
worse then.
How long will it take to get better?
Once the cause gets treated it should start to get better. Everyone is different,
some recover in hours, others in days or weeks. People with dementia or
head injuries may take longer.
Afterwards the person affected may not remember what has happened. Some
remember the vivid dreams and hallucinations. It can be helpful to talk about
what has happened with the medical or nursing staff.
If you become unwell again, it can recur. Further episodes of confusion can
be a warning sign of a further infection which should be treated as soon as
possible.
If the confusion continues we may ask a member of the psychiatric team for
advice.
Further information is available at:
NICE information leaflet for people with delirium, carers and those at risk of
delirium. http://www.nice.org.uk/nicemedia/live/13060/49911/49911.pdf
Information about you
As part of your care, when you come to the hospital, information about you is
shared between members of a healthcare team, some of whom you may not
meet. It may be used to help train any staff involved in your care. Information
we collect may also be used after you have been treated to help us to
maintain and improve the quality of our care, to plan services, or to research
into new developments.
We may pass on information to other health organisations to help improve the
quality of care provided by the NHS generally.
All information is treated as strictly confidential, and is not given to anyone
who does not need it. If you have any concerns please ask your doctor, or
the person caring for you.
Under the Data Protection Act (1998), Hull and East Yorkshire Hospital Trust
is responsible for maintaining the confidentiality of any information we hold on
you.
This leaflet has been produced by the Department of Medicine for the Elderly
at Hull and East Yorkshire Hospitals NHS Trust and will be reviewed in
September 2014.