doctor talking with senior man in hospital bed with his wife

With its similarities to dementia, delirium is often a confusing condition to understand and manage. Older adults tend to be vulnerable to delirium, so our senior care professionals have compiled the following details that can help you recognize and react accordingly in the event that you suspect it in somebody you love.

Details about delirium

Much like dementia, delirium symptoms include confusion, disorientation, and other changes in mental status. The key contrast, however, is the onset of these effects. In dementia, there is a progressive decrease in cognitive functioning; with delirium, the change is abrupt.

There are two kinds of delirium:

  • Hypoactive delirium is the most prevalent type, affecting around ¾ of people with delirium. It may present much like depression, with listlessness and a slowed response time. Other signs include apathy, a flat affect, and withdrawal from social situations or previously-enjoyed activities.
  • Hyperactive delirium causes agitation and restlessness, disorientation, hallucinations, anxiety, rambling, difficulty with concentration, and sudden changes in emotion.

It’s important to keep in mind that both forms of delirium can occur at the same time, with the person experiencing listlessness and drowsiness one moment and then feeling alert and agitated the next.

Who is most frequently impacted by delirium?

People at increased risk for delirium include:

  • Anyone who has been hospitalized or had a surgical procedure (as many as 10 – 30% of patients)
  • Those who are approaching the end of life
  • Patients in intensive care units
  • Seniors over age 75, especially those in assisted living facilities
  • People diagnosed with certain conditions: Parkinson’s disease, liver disease, stroke, cancer or HIV
  • Those receiving dialysis
  • People who take multiple medications or who are diagnosed with more than one chronic condition
  • Those who are hearing- or seeing-impaired

What causes delirium?

The root cause of delirium is often tricky to verify, but there are several known contributing factors:

  • Dehydration
  • Insufficient sleep
  • An extreme response to an infection
  • Withdrawal from alcohol or drugs or overdose
  • Medication side effects
  • Hyperthyroidism and hypothyroidism
  • Renal or liver issues
  • Pain

What should you do if you believe a loved one is delirious?

Consult with the older person’s physician immediately for an evaluation. They may do some simple initial tests, such as asking the person to solve a basic math problem or to spell a short word in reverse. An x-ray, physical exam, blood and urine samples, and imaging tests such as an MRI or CT scan may be ordered to help establish the cause.

What treatment solutions are available for delirium?

The medical condition or other reason for the delirium must first be identified and treated. Hospitalization is often needed to allow for uninterrupted monitoring of both the delirium itself and the treatment being provided. Options may include:

  • Fluids/electrolytes if the person is dehydrated
  • Antibiotics for any infections
  • Antipsychotic medications to ease hallucinations and agitation
  • Benzodiazepines if the delirium is related to alcohol or drug withdrawal

What can you do to provide support?

If looking after 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 calming music that the person enjoys.
  • Provide nutritious meals and ensure the person is drinking plenty of fluids.
  • Engage together in conversations to orient the individual.
  • Motivate the person to stay physically active (in accordance with the doctor’s instructions).
  • Try to establish regular sleeping patterns by keeping the home bright throughout the day, limiting daytime napping, and creating a calm, dark, quiet environment at night.

Hearts at Home In-Home Care, a provider of dementia care in Overland Park, KS and surrounding areas, can be a huge 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. Contact us at 913-440-4209 for a free in-home consultation to learn more.