Could a sudden behavior change be delirium?

Brain Health

by Sonya Flanders, RN, ACNS-BC

Jun 20, 2020

Delirium is a change in thinking and attention that comes on quickly, over a few hours or days. Family or friends are often the first to notice the changes that could signal delirium. If you notice such changes, reacting quickly is very important, because delirium can lead to other serious problems, such as falls, injuries and mental or functional decline that may last for weeks or longer.

If you think your loved one is experiencing symptoms of delirium, call their healthcare provider right away. If it occurs in a hospital setting, tell their nurse.

How can I recognize delirium?

Possible signs of delirium include:

  • A sudden change in thinking that might come and go over the day or night, such as being confused
  • A change in being able to pay attention or follow directions
  • A change in alertness, such as being anxious or being very withdrawn
  • Behaving differently than usual
  • Seeing or hearing things that are not there

What are some risks for delirium?

These things put an adult at higher risk for delirium:

Other things often add to the risk before delirium happens, such as:

  • Getting an infection
  • Certain medications
  • Unrelieved pain
  • Not sleeping
  • Having certain kinds of surgery
  • Being in a hospital, especially an intensive care unit

What is the difference between delirium and dementia?

The thinking changes that happen with delirium begin suddenly, over hours or days. Thinking changes with dementia happen more gradually over a longer time—usually months or years.

If my loved one is experiencing delirium, what can I do?

It can be upsetting to see someone you care about experiencing delirium. Here are some examples of things that may help.

  • Be calm, quiet and reassuring when you are with the person
  • Remind them where they are and why, and talk about current events, friends or family
  • Make sure they has hearing aids and glasses, if needed
  • Help promote rest at night

Another piece of advice is to work with your loved one’s healthcare team about what you can do to help. Be sure to let the doctors and nurses know about any questions or concerns you have. You can find more information about delirium at the Critical Illness, Brain Dysfunction and Survivorship Center (CIBS).

A final note: Changes in the way a person is acting are not always delirium. With any sudden change in thinking or behavior, contact a health care provider.

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About the Author

Sonya is an adult clinical nurse specialist with Baylor and moved to Texas from Canada to become a Baylor nurse. She's focused on enhancing health education of older adults along with their families and caregivers.

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