According to the Mayo Clinic, delirium is defined as “a serious change in mental abilities that results in confused thinking and lack of awareness of someone’s surroundings. The disorder usually comes on fast—within hours or a few days.”
Delirium is often confused with dementia, which is defined by the Mayo Clinic as “a gradual decline of memory and other thinking skills due to damage or loss of brain cells. The most common cause of dementia is Alzheimer’s disease.”
The two conditions share similar symptoms, which may make it difficult to distinguish between them. Complicating matters is that they can exist separately or together, and the fact that people with dementia are more prone to delirium than those without dementia.
Symptoms of Delirium
While dementia is a progressive disease that worsens over time with no recovery, people can recover from delirium. Delirium onset occurs without warning and may last hours, weeks or months. It manifests itself in many ways, including:
- An inability to focus
- Being easily distracted
- Withdrawal or lethargy
- Poor memory of recent events
- Difficulty speaking, reading or writing
- Disorientation
- Hallucinations
- Agitation and restlessness
- Sleep problems
Emotional disturbances can include:
- Anxiety
- Paranoia
- Depression
- Anger
- Euphoria
- Apathy
- Mood shifts
- Personality changes
Additional symptoms can include restlessness, pacing and the refusal to cooperate, which is referred to as hyperactive delirium. At the other end of the spectrum, hypoactive delirium is marked by inactivity, sluggishness, drowsiness or a dazed demeanor. Mixed delirium (both hyperactive and hypoactive delirium) can also occur. Many symptoms are shared by both conditions, including memory and language problems, and behavioral changes.
If your senior loved one shows signs of delirium, contact a physician, as the cause could be from a life-threatening illness. Discovering the underlying problem is necessary for treatment. As a family caregiver, your observations of your loved one’s behaviors will be critical to the diagnosis.
Causes of Delirium
Besides illness, contributing factors such as changes in metabolism or medications, or new infections or surgery, can lead to delirium. About a third of all seniors experience delirium during a hospitalization, and that number rises to 70% of seniors in intensive care units. The Mayo Clinic lists other factors that include:
- Alcohol or drug withdrawal
- Urinary tract infections (UTIs)
- Fever
- Exposure to a toxin
- Malnutrition or dehydration
- Emotional distress
- Pain
According to the Memorial Sloan Kettering Cancer Center, risk factors also include being 70 years old or older, past episodes of delirium, problems with seeing or hearing, and seniors who are taking five or more medications per day.
Testing and Recovery
Finding the cause of the delirium may require many tests—blood tests, X-rays, brain imaging, and EKGs. Physicians will ask questions about the senior’s medical history, past illnesses, and other details about the patient’s health.
Once a cause is found, recovery can happen rapidly, or issues with memory and other cognitive challenges can persist for months.
What Can Family Caregivers Provide?
There are some things that family caregivers can do to help their senior loved one experiencing delirium:
- Keep their room quiet and calm
- Encourage them to rest and sleep
- Make sure they are comfortable
- Make sure they have their glasses and hearing aids
- Encourage them to get up and sit in a chair during the day
- Emphasize drinking plenty of fluids
- Help them eat or drink if they need assistance
- Explain where they are and why
- Read to them
- Bring them familiar items
Memory Support at Bethesda
Bethesda’s memory support communities offer an easy-to-navigate environment, a full activity calendar, and staff that keeps residents involved and engaged with each other. The highly trained and experienced staff members understand the interplay between dementia and delirium and continually monitor the physical and emotional health of the residents there.
In keeping with its commitment, Bethesda’s memory support communities are not just a place to protect and support people with dementia. It is a place where human needs are met and interaction is encouraged by the facility’s design and philosophy of care.
For more information about our memory support services, contact us today. And find more resources on Bethesda’s Alzheimer’s and Dementia blog.
