There is no tablet that cures delirium. Treatment means finding and treating the causes, and supporting the person until the brain recovers.
Families often expect there to be a drug for it. There is not. Delirium is a sign that something else is wrong in the body, and the work is finding out what.
Treating the causes
The team should be looking for:
- infection
- new or changed medicines
- dehydration
- constipation or a full bladder
- pain that is not controlled
- low oxygen levels
- abnormal blood tests
Medicines are one of the commonest causes. Stopping the wrong medicine can help as much as starting the right one.
There is usually more than one cause, so the search should not stop at the first thing found. There is more about this in can a urine infection cause confusion?
Care that helps recovery
Glasses on and hearing aids in. Curtains open by day and lights down at night. Help with food and drink. Getting up and moving about. Familiar people at the bedside, and a clock and a calendar in view. These sound ordinary, but they shorten delirium and there is good evidence behind them. If you cannot see them happening, ask.
Sedative medicines
Sedatives are sometimes used in small doses, for short periods, when someone is so distressed or frightened that they are at risk. They treat the distress. They do not treat the delirium itself and they do not shorten it, and they carry their own risks in older people.
If sedation is suggested, it is reasonable to ask what has been tried first and how long it is meant to go on for.
When to get help
New confusion that has come on over hours or days needs medical advice the same day. Phone the GP practice, or 111 when it is closed. Phone 999 if the person cannot be woken, has collapsed, or has new weakness or new trouble speaking. When you speak to someone, say what has changed. Then ask: could it be delirium?