Case Study - Delirium

Marcus is a twenty five year old man with a mild intellectual disability. He lives in an SRS and has regular contact with his Disability support worker. Recently other residents have noticed that Marcus was behaving strangely at night time. They reported a great deal of noise coming from his room and he appeared to have been shouting at someone. This was out of character for Marcus who was usually a happy but reserved young man. In addition, residents reported that he was showering up to three times a day for long periods of time, including in the middle of the night. When asked about this he did not appear to remember that he had already had a shower nor that he had been in the shower for a long time. When his Disability case worker came to visit him, he initially did not recognise her and subsequently realised who she was by the sound of her voice. Given the sudden onset of behavioural changes and fluctuations in Marcus’ level of confusion, his case manager arranged an urgent medical review with his GP.  A low grade fever was detected and Marcus was admitted to hospital for further investigations. A chest X-Ray demonstrated a lower lobe pneumonia. Marcus was treated in hospital with intravenous antibiotics and his confusion resolved swiftly. His confidence and ability to function independently took a few days longer to improve, but with support from family and familiar staff, and increased levels of supervision in the short term, he was able to return successfully to his SRS.