Patients in intensive care often experience a condition known as delirium. This sheet provides an overview of delirium, its causes, and strategies to assist patients experiencing it.
What is Delirium?
Delirium refers to a state of acute confusion, often described as feeling trapped in a distressing dream. Patients may experience hallucinations, such as seeing non-existent objects or feeling threatened by imagined situations. They may not recognize their surroundings, believe in false scenarios, or misinterpret sensory information. These experiences can be frightening and confusing for both the patient and their loved ones.
Types of ICU Delirium
ICU delirium can present in two main forms: hyperactive and hypoactive. Hyperactive delirium is marked by agitation and restlessness, which can be challenging for caregivers and medical staff. Hypoactive delirium, on the other hand, is less noticeable but involves lethargy and reduced responsiveness. Both types can significantly impact a patient's behavior and response to their environment.
Causes of Delirium
Delirium in critically ill patients can result from several factors, including infections, medications, organ failure, and pre-existing conditions. Patients who are older, had cognitive issues before ICU admission, or were on certain medications are at higher risk. Ventilator use also significantly increases the likelihood of delirium.
Recognizing Delirium
Identifying delirium can be difficult, especially when patients are sedated. Medical staff may conduct daily tests to assess concentration levels if the patient is responsive. If you notice unusual behavior or distress in a loved one, inform the healthcare team for further evaluation.
Supporting the Patient
To support a patient with delirium, provide reassurance by holding their hand and frequently reminding them of their hospital environment. Engaging them in conversation, reading familiar materials, and maintaining a diary of their experiences can also be beneficial. Ensure any personal aids like glasses or hearing aids are used to help them stay oriented.
Duration and Effects
Delirium typically lasts from a few days to several weeks and may have lingering effects. While many patients recover fully, some may experience long-term cognitive issues. Delirium can also lead to vivid dreams and lingering emotional impacts even after recovery.
Post-Delirium Recovery
After experiencing ICU delirium, patients may have fragmented or distressing memories of their time in the ICU. Reflecting on their experience, reviewing any available patient diaries, and possibly revisiting the ICU can aid in processing and understanding their experience. Support from follow-up nurses or counselors can also be helpful.
Additional Support
For more information on delirium, a general awareness video is available on YouTube: Delirium Awareness Video. This resource is provided by ICUsteps, a charity dedicated to supporting ICU patients. For further assistance or donations, visit icusteps.org.