doctor talking with senior man in hospital bed with his wife

With its parallels to dementia, delirium is often a difficult condition to diagnose and manage. Older adults tend to be prone to delirium, so our senior care professionals have collected the following details that will help you recognize and react accordingly if you suspect it in somebody you love. Learn more facts about delirium below.

What is delirium?

Similar to dementia, delirium symptoms feature disorientation, confusion and other alterations in mental status. The key contrast, however, is the start of these symptoms. In dementia, there is a gradual decrease in cognitive functioning; with delirium, the transformation is faster.

There are 2 types of delirium:

  • Hypoactive delirium is the most common kind, affecting around three-quarters of individuals with delirium. It can display similarly to depression, with lethargy and a slowed response time. Other indications include apathy, a flat affect, and withdrawal from social situations or previously-enjoyed activities.
  • Hyperactive delirium triggers disorientation, anxiety, hallucinations, restlessness and agitation, difficulty concentrating, rambling, and sudden changes in emotion.

It’s important to note that both kinds of delirium can be experienced concurrently, with the person feeling drowsy and listless one moment followed by feeling alert and agitated the next.

Who is most often subject to delirium?

Those at increased risk for delirium include:

  • Anyone who has been hospitalized or had surgery (as many as 10 – 30% of patients)
  • Those who are getting close to the conclusion of life
  • Patients in intensive care units
  • Seniors over age 75, specifically those residing in nursing homes
  • People clinically determined to have certain conditions: stroke, Parkinson’s disease, HIV, cancer, or liver disease
  • 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 can be difficult to identify, but there are a number of known contributors:

  • Dehydration
  • Lack of sleep
  • An extreme response to an infection
  • Alcohol or drug withdrawal or overdose
  • Medication side effects
  • Hyperthyroidism and hypothyroidism
  • Kidney or liver issues
  • Pain

What should be done if you suspect a senior is delirious?

Get in contact with the senior’s doctor right away for an evaluation. They may perform some simple initial tests, such as asking the person 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 might be ordered to help establish the cause.

What treatment methods are available for delirium?

The medical condition or other reason for the delirium needs to first be established and addressed. Hospitalization is generally required to allow for continuous monitoring of the delirium itself as well as the treatment being delivered. Options can include:

  • Fluids/electrolytes in the event that 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 help?

If caring for the person with delirium at home, the following advice can help:

  • Reassure the individual that everything is alright and that you are right there.
  • Play comforting music that the person enjoys.
  • Provide healthy meals and ensure the person is drinking plenty of fluids.
  • Engage together in conversations to orient the individual.
  • Motivate the individual to stay physically active (based on the doctor’s guidelines).
  • Try to establish regular sleeping patterns by keeping the home bright throughout the day, limiting napping during the day, and creating a calm, dark, quiet atmosphere at night.

At-Home Care Company, a provider of home health care services in Des Moines, IA and nearby areas, can be a significant help as well for a person experiencing delirium. We are here for as much or as little assistance and support as needed, day or night. Contact us at 515-292-2650 for a free in-home assessment to find out more.