Technical information about the delirium quality measure.

September 20, 2009 by admin

The three most important things to understand about delirium are: 1. Delirium is a manifestation of illness, but it is not a disease itself (a good analogy is with pain - pain is not a disease, but rather a symptom that can be caused by many different diseases). 2. There are many diseases, which may cause delirium in an older person, and often there is more than one cause present at the same time. 3. Often the cause of delirium is at least partially treatable; and so, most residents with delirium will demonstrate some improvement with proper treatment. An important aspect of residents with delirium is that they get confused, and this confusion usually comes on very suddenly. This type of confusion also may fluctuate during the day and night. Confusion caused by delirium is different than confusion caused by dementia or Alzheimer's disease. The confusion associated with dementia usually comes on slowly, progresses gradually, and usually does not get better over long periods of time. Unfortunately, the most important risk factor for developing delirium is suffering from dementia to begin with. Both abnormal conditions (delirium and dementia) can cause confusion, but the confusion caused by delirium usually comes on faster, fluctuates more, and is more treatable than the confusion caused by dementia. One of the most common events in a confused nursing home resident is that they actually have both delirium and dementia at the same time. In that case, some confusion will remain even after good treatment of the delirium. The confusion that is left is caused by dementia. This cycle may reoccur in the future. There are many possible causes of delirium. The three most important ones are: infection, medications, and dehydration. It is common for people at the end of their lives to experience delirium. When an older person suddenly becomes confused or experiences a rapid increase in their confusion, delirium should be suspected, and a nurse should assess the resident as soon as possible. Further assessment by the doctor is also recommended. The purpose of the assessment will be to discover what is causing the delirium. Once the cause is determined, the proper treatment can be prescribed. For example, if the resident has pneumonia, then antibiotics can be prescribed. If a medication is causing delirium, most of the time that medication can be stopped or changed. If the resident is dehydrated, more fluids can be given by mouth, by feeding tube, or by the intravenous route. Some residents with delirium are found to be so sick that they require more intensive treatment.