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Dealing with delirium. A common problem in hospitalized elderly patients.

Delirium is a common problem, particularly in hospitalized elderly patients. It may be the first indication of serious illness, such as infection, cardiopulmonary disease, or a metabolic disturbance. The condition is precipitated by medications, toxins, and abrupt changes in environment. Delirium is often a frightening experience for patients and families and a challenge to treat. As the elderly population increases, physicians may expect to encounter this condition more often. Maintaining a high index of suspicion may prevent many cases and arrest others at onset. Proper management includes prompt diagnosis and treatment of the underlying illness, as well as use of commonsense measures to calm and reassure the patient.