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
- difficulty passing stools or urinary retention, which means being unable to empty the bladder
- pain that is not controlled
- low oxygen levels
- problems shown by blood tests
Medicines are a common cause. The treating doctor or nurse should review them and decide whether any need to be stopped or changed.
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 ordinary measures are part of care and may shorten delirium. If you can’t see them happening, ask.
Medicines for severe distress
An antipsychotic medicine may sometimes be used for severe distress or risk of harm when calm support has not helped. The team should use the lowest appropriate dose for the shortest possible time. These medicines do not treat the causes of delirium or reliably shorten it. They can cause drowsiness and other serious side effects, especially 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
Delirium (acute confusion) is a medical emergency. Outside a care setting, call local emergency services now. In a hospital, care home or nursing home, tell staff immediately. Say what has changed and ask whether it could be delirium.