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Delirium

 

What is delirium?

Delirium is a change in the way people think, feel, and behave that is caused by a medical condition or treatment. If we know your child has delirium, we can treat it. Treatment might include fixing the causes of the delirium, giving medicines, and changing your child’s surroundings.

Delirium that is not treated can cause you and your child more distress and confusion. It can raise your child’s risk of injury or death. Your child might also have problems getting treatment or have to stay longer in the hospital.

What are the signs of delirium?

You might think that your child has never behaved like this before. For example, they might:

  • Act confused — Not knowing where they are or who you are.
  • Say things that don’t make sense.
  • See or hear things that aren’t there.
  • Act upset or angry—The usual ways you calm them down don’t work.
  • Sleep too much or too little— Or sleep a lot in the daytime and stay awake at night.
  • Act different than usual —More scared, jumpy, restless, watchful, suspicious, angry, or disinterested.
  • Refuse medicines, pull on IV lines, or not listen to instructions.

What can cause delirium?

  • An infection or fever
  • Medicines— Such as some chemotherapy drugs and steroids
  • Being admitted to the intensive care unit, or ICU
  • Breathing problems, including getting a breathing tube put in
  • Problems with the body’s chemical balance —You might hear the doctor or nurse call this “electrolytes” or the “electrolyte balance.”
  • Sleep problems
  • New surroundings

How the St. Jude team checks for delirium and treats it

Your child’s St. Jude team will watch your child’s behavior closely. This includes checking if your child is confused, restless, or has other possible signs of delirium.

Delirium can come and go quickly. Or it can last several days or weeks. Treating delirium often involves finding the main causes and treating them. The St. Jude team can do things to help your child, including giving medicines and changing surroundings if needed. Your child’s doctor will ask the mental health care team to help treat your child’s delirium.

Why does my child need mental health services?

Mental health care providers are trained to find the causes of delirium and help stop it or keep it from getting worse. For example, a psychiatrist can prescribe medicine to treat delirium. They can also check your child’s regular medicines to learn if any of them could cause delirium.

Delirium does not mean your child is mentally ill. It means their physical illness is affecting their thinking, behavior, and emotions. The St. Jude psychiatry team may care for your child as long as the delirium lasts. They might help longer if your family has other needs.

How can I help my child?

Here are some things you can try. You can remember them with the words “CARES FOR.”

Communication Use clear, slow, simple words or phrases. Repeat things, and tell your child who you are. You might need to do this often while they have delirium.
Activity Avoid keeping your child restrained, such as using a “seat belt” to keep them in bed. Encourage your child to do things for themselves.
Re-orientation Re-orient your child to where they are, who you are, and what day and time it is. “Reorient” means to remind them, even if you think they should know.
Environment Make sure your child’s room is light in the daytime and dark at night. Try to keep the room quiet when your child is calm or resting. Avoid having the TV on when your child is not watching it.
Sleep Help your child stay awake most of the day if possible. Your child might not always stay awake during the day because of medicines or procedures. But sleeping less during the day helps your child sleep more at night.
Familiar things Give your child familiar things, such as a favorite toy. Play music they know. Bring objects from home to your child’s room. Avoid having visitors your child does not know well. Ask your St. Jude team about having familiar staff members care for your child.
Out of bed Help your child sit up in bed, get out of bed, and walk around as much as possible.
Reassure Reassure and comfort your child. Tell them they will be OK and that you or another loved one will stay with them.

Questions?

If you have questions about delirium, please contact the Psychiatry department at St. Jude. If your child is in the hospital, you can call 901-595-0388 or 901-595-0389 to reach a doctor. If your child is at home or in St. Jude housing and you think they might have delirium, you can bring them to the Medicine Room.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

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