DRUGS AND DELIRIUM

Anti-psychotic medications are routinely prescribed for delirium. However if the delirium is due to anesthesia, a drug, an electrolyte imbalance or infection and the effects will wear off relatively soon. It would be much wiser given the side effects, to just have someone stay with the individual. Non-drug support works much more effectively especially with the elderly than introducing yet another drug.

Side effects are far ranging such as; loss of balance, restlessness, trembling, difficulty urinating, weakness, dizziness, skin rash, and even unusual movements of the mouth, arms and legs. When these drugs are used, the family member should be given a complete list of the drugs side effects.

Delirium is a very frustrating condition for the patient. It causes misinterpretation of their environment. Keeping the patient informed of what day it is, what time of day it is, what has happened, where they are and what is going on right now is very important. Often if the patient is hallucinating they will tell you that they know what they are seeing, can’t be true, but they are seeing it anyway.

These drugs may be introduced just because it is difficult to care for someone who is delirious. However many elderly people being discharged from the hospital, are now leaving on powerful anti-psychotic medications due to delirium. The problem arises when the patient is no longer delirious due to the infection, surgery or medical condition that caused it in the first place. But now they are suffering from the side effects of the drug.

What does work for delirium? Studies now show that the quickest way to recover from delirium is to get moving. Having patients get out of bed and start walking it off, turns out to be the best and safest medicine yet. Make sure the patient is hydrated, there is a reason patients come out of surgery with IV solutions. Make sure the patient is exposed to sun light during the day and in a dark room at night so that they return to their normal sleep/awake cycle.

And most of all provide that one on one caregiver, who can explain the environment while reassuring the patient that all is well and they are safe.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing