Delirium: Conviction and Conundrum

“A new consult for delirium,” said the provider from the primary team. When I inquired,* the elicited details were reported in a rote but familiar fashion: Mr. A, a gentleman in his mid-70s with underlying dementia, had been admitted after a motor vehicle accident in which he was the passenger. He had sustained multiple broken ribs. During his initial week in the hospital, he had periods of worsening confusion and sometimes agitation, requiring frequent supervision. Since these behaviors impacted his care and brought about safety concerns, he received medication to help keep him calm.