Sudden confusion calls for immediate action
Someone who was in their usual state and suddenly becomes confused needs immediate medical assessment. Do not wait for a geriatric appointment or a WhatsApp reply. Some causes can be life-threatening. In Israel, call Magen David Adom on 101 for urgent help.
What is delirium?
Delirium is an acute change in brain function that may involve difficulty paying attention, altered alertness and confusion. It usually develops over hours to days, and symptoms may fluctuate during the day.
Someone may struggle to follow a conversation, answer in an unusual way or not understand where they are. Moments of apparent clarity are not a reason to dismiss a new, abrupt change.
Not everyone with delirium is agitated
Some people become restless, frightened or behave unusually. Others are quieter than usual, sleepy, slow to respond or less interested in their surroundings. A person may move between these patterns.
Notice new reductions in alertness and engagement, not only disruptive behaviour. A change that clearly differs from the person’s usual state needs assessment.
What can cause sudden confusion?
Possible causes include infection, dehydration, electrolyte imbalance, acute illness, medication effects or withdrawal of certain medicines. Several factors may occur together. Hospital admission or surgery can also be part of the setting in which delirium develops.
Other emergencies, including stroke, low blood sugar and head injury, can also cause confusion. It is not possible to decide at home that it is “just an infection” or “just a medicine”.
What if the person already has dementia?
Delirium and dementia are different conditions, but can occur together. Dementia usually develops over time, while delirium involves a more acute change.
Describe what has changed from the person’s usual speech, alertness and abilities. Do not automatically attribute sudden deterioration to existing dementia.
What can you do while waiting for help?
Stay with the person, speak in short sentences and gently explain who you are and where they are. Avoid overwhelming them with questions or testing their memory. If possible, prepare their medicines and medication list.
Do not add a sleeping tablet or sedative on your own. Some medicines can contribute to confusion, and treatment must follow medical assessment.
Can someone recover from delirium?
Treatment focuses on identifying and addressing the causes. Improvement is possible, but recovery is not always immediate and may take weeks or longer. Follow-up of memory, everyday function and medicines may be needed afterwards.
