Harvard Mental Health Letter

Recognizing and managing delirium

During illness, hospitalization, or recovery, some people experience delirium, a rapidly developing and severe confusion accompanied by altered consciousness and an inability to focus. It's one of the most common complications of hospitalization among older people, affecting as many as 20% of those ages 65 and over who are admitted to hospitals. There are different types of delirium. In hyperactive delirium, people may become agitated, noisy, prone to hallucination, and possibly belligerent. This type of delirium is more typical of withdrawal from alcohol or psychoactive drugs, but occurs relatively rarely in people who have delirium related to illness or hospitalization. Far more common is hypoactive delirium, in which the patient may be equally disoriented but is withdrawn, drowsy, or difficult to wake. Some patients also fluctuate between the two states. The first step in treatment is identifying the underlying cause or causes. 
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