Treatment of Delirium
Key Points for This Section
- Where the patient is living, such as home, hospital, or nursing home.
- How advanced the cancer is.
- How the delirium symptoms are affecting the patient.
- The wishes of the patient and family.
Treating the causes of delirium usually includes the following:
- Stopping or lowering the dose of medicines that cause delirium.
- Giving fluids to treat dehydration.
- Giving drugs to treat hypercalcemia (too much calcium in the blood).
- Giving antibiotics for infections.
In a terminally ill patient with delirium, the doctor may treat just the symptoms. The doctor will continue to watch the patient closely during treatment.
Controlling the patient's surroundings may help with mild symptoms of delirium. The following may help:
- Keep the patient's room quiet and well-lit, and put familiar objects in it.
- Put a clock or calendar where the patient can see it.
- Have family members around.
- Keep the same caregivers as much as possible.
Patients who may hurt themselves or others may need to have physical restraints.
Medicines may be used to treat the symptoms of delirium depending on the patient's condition and heart health. These medicines have serious side effects and the patient will be watched closely by a doctor. These medicines include the following:
When the symptoms of delirium are not relieved with standard treatments and the patient is near death, in pain, or has trouble breathing, other treatment may be needed. Sometimes medicines that will sedate (calm) the patient will be used. The family and the health care team will make this decision together.
The decision to use sedation for delirium may be guided by the following:
- The patient will have repeated assessments by experts before the delirium is considered to be refractory (doesn't respond to treatment).
- The decision to sedate the patient is reviewed by a team of health care professionals and not made by one doctor.
- Temporary sedation, for short periods of time such as overnight, is considered before continuous sedation is used.
- The team of health care professionals will work with the family to make sure the team understands the family's views and that the family understands palliative sedation.