Understanding Delirium: A Closer Look at Sudden Confusion

Delirium is a sudden change in a person’s thinking, attention, and awareness. It usually comes on quickly (hours to days) and can make someone feel confused, disoriented, or less alert than usual. The word “delirium” comes from Latin, meaning “to go off the furrow,” or stray from a clear path. Doctors have written about symptoms like delirium for centuries, but it was more clearly described and studied in the 1800s as doctors began to better understand mental health and brain function.

Delirium is most common in older adults, especially those over 65. It often happens during a hospital stay or after surgery. People who already have memory problems, such as dementia, are at higher risk. Other risk factors include infections (like urinary tract infections or pneumonia), severe illness, dehydration, or taking multiple medications, especially ones that affect the brain. Even a small health issue can cause delirium in someone who is already frail or has several health conditions.

Doctors diagnose delirium by talking with the patient and their family and by observing changes in behavior. Geriatricians (doctors who specialize in caring for older adults), hospitalists, and neurologists are most likely to evaluate it. At home, family members might notice signs like sudden confusion, trouble focusing, restlessness, or changes in sleep. If a loved one seems very different from their usual self with changes occurring over a short period of time, it’s important to call a doctor. This is especially true if they suddenly don’t recognize people, seem unusually sleepy, or start saying things that don’t make sense.

Treating delirium usually means finding and fixing the cause. For example, treating an infection or adjusting medications can often help. Creating a calm, familiar environment, making sure the person has enough fluids, and helping them stay oriented with clocks and calendars can also make a big difference. If symptoms don’t improve or if the person becomes a danger to themselves or others, they may need hospital care. While delirium can be scary to see, most people get better once the cause is treated. Some recover fully within days, while others may take longer. In people with dementia, recovery might be slower, or less complete but early action and support can lead to a better outcome.

Dr. Allen Fellers is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.