Delirium is a type of mental confusion that comes on quickly, usually over a few hours or days. Patients with delirium may have the following symptoms:
Trouble focusing their attention and are easily distracted
Extremely mentally excited and restless, or quiet and drowsy.
Hallucinations
Sometimes what they say makes no sense.
Symptoms may get better or worse at different times of the day

A common time for delirium to happen is during or after an older person is in the hospital or when they are recovering from surgery.

Medical research has found that older people who have a medical illness or surgery do not recover as well if they develop a delirium. Delirium after surgery or during a medical illness even increases an older person’s chance of dying.

Things which make it more likely that delirium will happen include being very old and having a history of alcohol abuse, dementia, and problems seeing or hearing. Delirium can also be a sign of a medical problem, such as severe anemia (low levels of red blood cells or hemoglobin), pneumonia, bladder infection, or poorly controlled diabetes. People who are bedridden for a long time can develop a delirium.

New Research in the Journal of the American Geriatrics Society (JAGS)

Medical researchers in Sweden studied patients 70 years of age and older admitted to a general internal medicine ward of a hospital to find out whether an educational program for health care staff and reorganizing the system of nursing and medical care would improve how well patients recover after they develop delirium. Patients who were admitted over an 8-month period were placed randomly in one of two wards ­ an “intervention” ward and a “control” ward (200 patients were admitted to each ward). Within 24 hours of admission to the hospital, medical staff examined each patient with standardized tests to determine if the patient had delirium. There were 63 patients on the intervention ward and 62 on the control ward who had delirium.

Patients on the control ward were taken care of by hospital staff in a manner that was based on a “task-allocation care system”, in which the same staff member did the same task for all patients. For example, the same staff person might take blood pressure and temperature for all patients on the ward.

Patients on the intervention ward were taken care of by hospital staff in a manner that was based on a “patient allocation system”, in which teams made up of one registered nurse and one licensed practical nurse were responsible for a small number of patients and all of their nursing care through their stay on the hospital ward.

The staff on the intervention ward received the following training as well:
1) A two-day course for medical and nursing staff focusing on delirium,
2) Education about how to work with patients with delirium, emphasizing the care performed and the manner in which it is provided,
4) Follow-up guidance for nursing staff once a month.

When the control ward patients were compared to the intervention ward patients, the researchers found that:
The average number of days in the hospital was shorter for patients with delirium if they were taken care of on the intervention ward rather than if they were on the control ward (10.8 days on the intervention ward versus 20.5 days on the control ward).
More patients with delirium on the intervention ward were able to return to their own house or apartment (78%) compared to patients with delirium who were on the control ward (60%).
Two patients with delirium on the intervention ward died during the study, compared to nine patients with delirium on the control ward died during the study.

The researchers concluded that patients with delirium admitted to the general medicine department in the hospital who received the intervention were able to be in the hospital for a shorter length of time, and the delirium didn’t last as long. Also, the older patients with delirium were less likely to die if they received the intervention, compared to patients with delirium who were admitted to the regular hospital ward.

The summary above is from the full report entitled “A Multifactorial Intervention Program Reduces the Duration of Delirium, Length of Hospitalization, and Mortality in Delirious Patients.” It is in the April 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue 4, pages 622-628). The report is authored by Maria Lundstrom, RN, PhD, Agneta Edlund, RN, Stig Karlsson, RN, PhD, Benny Brannstrom, RN, PhD, Gosta Bucht, MD, PhD, and Yngve Gustafson, MD, PhD.