Along with its parallels to dementia, delirium is often a complicated condition to diagnose and treat. Seniors are particularly at risk of delirium, so our aging care experts have compiled the following delirium facts and information to help you recognize and respond accordingly in the event that you suspect it in someone you love.
Facts about delirium
Much like dementia, delirium symptoms involve confusion, disorientation, and other alterations in mental status. The key difference, however, is the onset of these symptoms. In dementia, there is a slow decline in cognitive functioning; with delirium, the change is abrupt.
There are two types of delirium:
- Hypoactive delirium is the most prevalent form, impacting roughly three-quarters of people with delirium. It may display similarly to depression, with listlessness and a slowed reaction time. Other indications include a flat affect, withdrawal from social/once-enjoyed activities, and apathy.
- Hyperactive delirium triggers disorientation, anxiety, hallucinations, restlessness and agitation, difficulty concentrating, rambling, and sudden changes in emotion.
It is important to note that both kinds of delirium can occur at the same time, with the person feeling drowsy and listless one minute followed by feeling agitated and alert the next.
Who is typically impacted by delirium?
People at increased risk for delirium include:
- Anyone who has been hospitalized or had surgery (as many as 10 – 30% of patients)
- Those who are nearing the end of life
- Intensive care unit patients
- Seniors over age 75, specifically those residing in assisted living facilities
- People diagnosed with certain ailments: stroke, Parkinson’s disease, HIV, cancer, or liver disease
- Those receiving dialysis
- People who take multiple medications or are diagnosed with multiple chronic illnesses
- Those who are hearing- or seeing-impaired
What causes delirium?
The root cause of delirium can be hard to pinpoint, but there are several known contributors:
- Lack of sleep
- An overwhelming response to an infection
- Alcohol or drug withdrawal or overdose
- Medication side effects
- Hypothyroidism and hyperthyroidism
- Renal or liver issues
What should you do if you believe a loved one is delirious?
Contact the senior’s healthcare provider right away for an assessment. They may do some simple initial tests, like asking the individual to solve a standard math problem or to spell a short word in reverse. A physical exam, blood and urine tests, and imaging tests like an MRI, CT scan, or x-ray may be ordered to help determine the cause.
What treatment solutions are available for delirium?
The medical condition or other cause of the delirium should first be identified and treated. Hospitalization is often required to allow for uninterrupted monitoring of both the delirium itself and the treatment being provided. Options can include:
- Fluids/electrolytes if the person is dehydrated
- Antibiotics for any infections
- Antipsychotic medications to help ease hallucinations and agitation
- Benzodiazepines if the delirium is related to alcohol or drug withdrawal
What can you do to provide support?
If caring for an individual with delirium at home, the following suggestions can help:
- Reassure the person that everything is ok and that you are right there.
- Play comforting music that the person enjoys.
- Provide healthy meals and ensure the individual is drinking plenty of fluids.
- Engage in conversations together to orient the individual.
- Motivate the individual to remain physically active (according to the doctor’s instructions).
- Try to establish regular sleeping patterns by keeping the home bright during the day, limiting napping during the day, and creating a calm, dark, quiet environment in the evening hours.
Home With You Senior Care, a provider of dementia care in Howard County and surrounding communities, can be a tremendous help as well for a person with delirium. We are here for as much or as little assistance and support as needed, day or night. Reach out to us at 410-756-0959 for a complimentary in-home consultation to learn more.