Delirium is a serious mental disorder that causes sufferers to experience severe confusion and reduced awareness of the surrounding environment. Mental disorders are caused by rapid changes in brain function that occur together with mental or physical illness. As a result, people with delirium have difficulty thinking, remembering, concentrating, or sleeping. The condition of delirium can be frightening for sufferers and those around them. Delirium is usually temporary by controlling the causes and triggers.
Symptoms and Types of Delirium
Patients will show symptoms of changes in mental condition when experiencing delirium in a few hours to several days. Some of these symptoms include:
- Reduced awareness of the surrounding environment. This condition is characterized by difficulty focusing on the topic or changing the topic of conversation, easily distracted by things that are not important, and daydreaming so that they do not react to things that happen around them.
- Poor thinking ability (cognitive impairment). This condition is characterized by poor memory, especially for the short term, disorientation, difficulty speaking or remembering words, long-winded speech, and difficulties in understanding speech, reading and writing.
- Emotional disorders. Delirium sufferers will appear nervous, afraid or paranoid, depression , irritability, apathy, sudden mood changes, and personality changes.
- Changes in behavior. Others will see delirium sufferers experiencing hallucinations, anxiety and aggressive behavior, issuing a sound of groaning or calling, becoming quiet and shut down, slowing movements, and disrupting sleep habits.
Based on the symptoms shown by patients, delirium can be divided into several types, namely:
- Delirium is hyperactive . Patients will look nervous, often changing their mood or hallucinating. This symptom is most easily recognized.
- Delirium is hypoactive . Patients will appear inactive or reduce movement activity, lethargy, drowsiness or look dazed.
- Delirium mixture . Patients will often show changes in symptoms from hyperactive delirium to hypoactive delirium or vice versa.
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Causes and Risk Factors of Delirium
Many conditions can cause the brain to not get oxygen supply or experience interference, resulting in delirium. Some factors that can cause delirium include:
- Take certain drugs or drug poisoning. The types of drugs that cause accumulation of substances in the brain are painkillers, sleeping pills, allergy (antihistamines), drugs for asthma, corticosteroids , drugs for seizures, drugs for Parkinson's disease , and drugs for mood disorders.
- Alcoholism and alcohol withdrawal symptoms.
- Poisoning, for example cyanide or carbon monoxide .
- Other medical procedures or procedures involving anesthesia.
- Chronic or severe disease, such as kidney failure.
- Malnutrition or dehydration.
- Sleep disorders or emotional disorders.
- Electrolyte disorders .
- Fever due to acute infection, especially in children.
- Having abnormalities in the brain.
- Aged or over 65 years of age.
- Have experienced delirium before.
- Having impaired vision or hearing.
- Have a combination of several diseases.
In order to make a diagnosis of delirium, the doctor needs to ask the patient's disease history. In addition, information from the family or the person closest to the patient is also needed so that the diagnosis becomes accurate.
There are several checks that doctors can do to diagnose delirium, namely:
- Physical and neurological examination. The doctor will do a physical examination to check for disorders or diseases that can cause delirium, and to determine the patient's level of awareness. On a neurological examination, the doctor will check the condition of vision, balance, coordination, and reflexes.
- Examination of psychiatric conditions. The doctor will assess the patient's mental state, attention, and thinking through interviewing, testing and screening sessions.
- Supporting investigation. Your doctor may suggest several other tests to determine if there is a disturbance in the body. Among them are blood or urine tests for liver function tests , assessing thyroid hormone levels, exposure to drugs or alcohol. In addition, imaging tests can also be performed, in the form of imaging the head with a CT scan or MRI, electroencephalogram and chest X-ray. If needed, analysis of cerebrospinal fluid will be carried out to confirm the diagnosis of delirium.
Treatment of Delirium
The main goal of treatment is to deal with the causes of delirium. For example, in delirium caused by consumption of drugs, the doctor will advise to stop or reduce the dose of the drug. After that, handling is intended to create an environment that is suitable for the recovery of the body and soothe the sufferer's mind.
In addition to dealing with causes, symptoms that arise are also overcome. For people with delirium who experience anxiety, fear, or hallucinations, they will be given sedatives to prevent harm to other people and the environment. Provision of medication can be reduced or stopped after symptoms of delirium subside.
There is also support therapy that aims to prevent complications. Some supporting therapies that can be given include:
- Keep the airway not closed.
- Providing fluids and nutrients needed by the patient's body.
- Helps sufferers who have difficulty moving the body.
- Deal with pain experienced by sufferers.
- As much as possible avoid restraining the body by being tied up, installing a urine catheter, and too many changes in the environment around the sufferer.
- Talk to patients with simple, short sentences.
- Trying to remind patients about the time, date, and what happened at that time.
- Stay calm while listening to patients.
- Help patients while eating and drinking.
- For patients who are hospitalized, bring things that are known to patients from home.
- Turn on the lights at night so patients can see the surrounding conditions when they wake up.
Complications of Delirium
Delirium can cause medical complications, especially in patients with serious diseases, including a decrease in general health conditions, and healing that does not work well after surgery.
Prevention of Delirium
Some things that can be done to avoid the occurrence of delirium and prevent delirium get worse, namely:
- Avoiding the risk factors for exacerbating delirium, such as changing the atmosphere of the environment or making noise.
- Applying healthy sleep habits. Provide a quiet room and environment, good lighting, including helping sufferers to have a balanced activity during the day, can help them sleep better at night.
- Continue to strive to create a calm and stable atmosphere. This includes placing items that are known to the patient around him, providing a clock and calendar, and trying to speak in a low voice so that the patient is not disturbed.
- Ensure that patients undergo a healthy diet, take medicines according to the doctor's recommendations, and exercise regularly.