With its similarities to dementia, delirium can be difficult to identify and manage. Older adults are especially at risk of delirium, so our in-home care experts have put together the following facts on delirium causes and treatments that will help you recognize and react appropriately if you suspect it in somebody you love.
What is delirium?
Similar to dementia, delirium symptoms feature confusion, disorientation, and other changes in mental status. The important difference, however, is the onset of these symptoms. In dementia, there is a gradual decrease in cognitive functioning; with delirium, the transformation is sudden.
There are two types of delirium:
- Hypoactive delirium is the most common type, affecting approximately three-quarters of individuals with delirium. It can present like depression, with listlessness and a slowed response time. Other indications 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 swift changes in emotion.
It is important to bear in mind that both kinds of delirium can occur at the same time, with the person experiencing listlessness and drowsiness one moment followed by feeling agitated and alert the next.
Who is most frequently impacted by delirium?
Those 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 conclusion of life
- Intensive care unit patients
- Seniors over age 75, specifically those staying in nursing facilities
- People diagnosed with certain ailments: Parkinson’s disease, liver disease, stroke, cancer or HIV
- Individuals getting dialysis
- People who take multiple medications or who are diagnosed with multiple chronic illnesses
- Those who are hearing- or seeing-impaired
What causes delirium?
The root cause of delirium is often not easy to establish, but there are a number of known contributors:
- Insufficient sleep
- An extreme response to an infection
- Alcohol or drug withdrawal or overdose
- Side effects of certain medications
- Hyperthyroidism and hypothyroidism
- Kidney or liver issues
What should be done if you suspect a senior is delirious?
Consult with the senior’s healthcare provider immediately for an assessment. They may perform some simple initial tests, such as 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 might be ordered to help diagnose the cause.
What treatment solutions are available for delirium?
The medical condition or other reason for the delirium must first be established and addressed. Hospitalization is often needed to allow for ongoing monitoring of both the delirium itself and the treatment being provided. Options include:
- Fluids/electrolytes if the person is dehydrated
- Antibiotics for any infections
- Antipsychotic medications to ease 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 the individual with delirium at home, the following tips can help:
- Reassure the individual that everything is ok and that you’re right there.
- Play relaxing music that the person likes.
- Provide nutritious meals and make certain 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 instructions).
- Try to establish regular sleeping patterns by keeping the home bright during the day, limiting daytime napping, and creating a calm, dark, quiet environment in the evenings.
Morning Glory Home Care, a trusted provider of senior care in Edwardsville, IL and surrounding areas, can be an enormous help as well for someone with delirium. We are here for as much or as little assistance and support as needed, day or night. Contact us at 618-667-8400 for a complimentary in-home assessment to find out more.