doctor talking with senior man in hospital bed with his wife

With its similarities to dementia, delirium tends to be a challenging condition to diagnose and manage. Older adults are especially at risk for delirium, so our aging care experts have put together the following information that will help you recognize and react accordingly if you suspect it in a person you love.

What is delirium?

Similar to dementia, delirium symptoms feature confusion and disorientation, as well as other alterations in mental status. The important contrast, however, is the onset of these symptoms. In dementia, there is a slow and gradual decrease in cognitive functioning; with delirium, the change is immediate.

There are two types of delirium:

  • Hypoactive delirium is the most common type, affecting roughly ¾ of people with delirium. It may present similarly to depression, with listlessness and a slowed response time. Other symptoms include apathy, a flat affect, and withdrawal from social situations or previously-enjoyed activities.
  • Hyperactive delirium produces disorientation, anxiety, hallucinations, restlessness and agitation, difficulty concentrating, rambling, and quick changes in emotion.

It is important to bear in mind that both forms of delirium can be experienced concurrently, with the person experiencing listlessness and drowsiness one minute and then feeling alert and agitated the next.

Who is usually impacted by delirium?

People at heightened risk for delirium include:

  • People who have been hospitalized or had surgery (as many as 10 – 30% of patients)
  • Those who are getting close to the end of life
  • Intensive care unit patients
  • Seniors over age 75, particularly those residing in nursing homes
  • People clinically determined to have certain conditions: stroke, Parkinson’s disease, HIV, cancer, or liver disease
  • Individuals receiving dialysis
  • People taking multiple medications or diagnosed with more than one chronic illness
  • Hearing- or sight-impaired individuals

What causes delirium?

The primary cause of delirium is often difficult to pinpoint, but there are several known contributing factors:

  • Dehydration
  • Insufficient sleep
  • An extreme response to an infection
  • Alcohol or drug withdrawal or overdose
  • Side effects of certain medications
  • Hyperthyroidism and hypothyroidism
  • Renal or liver problems
  • Pain

What should you do if you believe a senior is delirious?

Talk to the older person’s healthcare provider right away for an assessment. They may perform some simple initial tests, like asking the person to solve a standard math problem or to spell a short word backwards. A physical exam, blood and urine tests, and imaging tests like an MRI, CT scan, or x-ray may be ordered to help identify the cause.

What treatment is available for delirium?

The health condition or other reason for the delirium should first be identified and treated. Hospitalization is oftentimes needed to allow for ongoing monitoring of the delirium itself as well as the treatment being provided. Options can include:

  • Fluids/electrolytes in the event that person is dehydrated
  • Antibiotics for any infections
  • Antipsychotic medications to help relieve agitation and hallucinations
  • Benzodiazepines in the event that delirium is related to alcohol or drug withdrawal

What can you do to help?

If taking care of someone with delirium at home, the following suggestions can help:

  • Reassure the person that everything is ok and that you’re right there.
  • Play soothing music that the person likes.
  • Provide balanced meals and ensure the individual is drinking plenty of fluids.
  • Engage in conversations together to orient the individual.
  • Motivate the person to stay physically active (in accordance with the doctor’s guidelines).
  • Try to establish regular sleeping patterns by keeping your home bright during the day, limiting napping during the day, and creating a calm, dark, quiet atmosphere in the evening hours.

Compassionate Nursing Services, a provider of home and memory care in Clayton, MO and nearby areas, can be an enormous help as well for a loved one experiencing delirium. We are here for as much or as little assistance and support as needed, day or night. Call us [8] at 314-432-4312 for an in-home evaluation to find out more.