QUESTION: We received a phone call from the administrator of the nursing home in which our father now lives.
He told us Dad has become unmanageable, and confused.
He mentioned the word "delirium" as the diagnosis.
What does this mean and what should we do?
ANSWER: I am obliged to make a few guesses about your situation in the absence of more complete information, but the question is so important that it deserves an answer.
Delirium is sometimes used as a diagnosis for a wide variety of symptoms stemming from different causes, but most frequently is applied when the patient becomes confused and disoriented, lacks the ability to concentrate, and shows abnormal thinking and loss of memory.
The pattern of behavior is extremely variable and can change literally from hour to hour depending upon the causes.
And the disorders which can provoke this condition are many, including heart problems: congestive heart failure, rhythm difficulties, and abnormal blood pressure; infections: pneumonia and urinary infections to name but two; metabolic problems: including dehydration, anemia, vitamin and mineral deficiencies, and chemical imbalance of vital elements in the blood.
Problems in the central nervous system and mild strokes may also be underlying cause for delirium, but in an elderly man, who I must suppose takes a number of medications, it is the possibility of drug toxicity and medication side affects that should be explored first. Medications used for sleep, as analgesics, antihistamines, for stomach problems, digitalis, insulin and other medications for diabetes, may all provoke the symptoms of delirium in certain cases.
The good news is that merely stopping these medications or altering the dosages may speedily return the patient to a normal pattern of thinking and behavior.
Your course of action is clear.
Your Dad deserves a first class workup by a competent and concerned physician that has experience in dealing with these problems.
It may mean a trip for you to visit your Dad, but I assure you that the results can be well worth it.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
