doctor talking with senior man in hospital bed with his wife

With its similarities to dementia, delirium can be a complicated problem to understand and manage. Seniors are especially prone to delirium, so our aging care experts have collected the following details that will help you recognize and respond appropriately in the event that you suspect it in somebody you love.

What is delirium?

Similar to dementia, delirium symptoms consist of disorientation, confusion along with other changes 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 immediate.

There are 2 forms of delirium:

  • Hypoactive delirium is the most prevalent type, impacting around three-quarters of people with delirium. It can present like depression, with listlessness and a slowed response time. Other signs include a flat affect, withdrawal from social/once-enjoyed activities, and apathy.
  • Hyperactive delirium causes disorientation, anxiety, hallucinations, restlessness and agitation, difficulty concentrating, rambling, and quick changes in emotion.

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

Who is most frequently impacted by delirium?

People at heightened risk for delirium include:

  • Individuals who have been hospitalized or who have had a surgical procedure (as many as 10 – 30% of patients)
  • People who are nearing the end of life
  • Patients in the ICU
  • People over age 75, particularly those living in nursing homes
  • People diagnosed with certain conditions: stroke, Parkinson’s disease, HIV, cancer, or liver disease
  • Individuals receiving dialysis
  • People who take multiple medications or who are diagnosed with multiple chronic illnesses
  • Hearing- or seeing-impaired individuals

What causes delirium?

The root cause of delirium can be tough to verify, but there are a number of known contributing factors:

  • Dehydration
  • Lack of sleep
  • An overwhelming response to an infection
  • Alcohol or drug withdrawal or overdose
  • Medication side effects
  • Hyperthyroidism and hypothyroidism
  • Renal or liver problems
  • Pain

What should you do in the event that you suspect a senior is delirious?

Get in contact with the older person’s doctor 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. A physical exam, blood and urine tests, and imaging tests like an MRI, CT scan, or x-ray might be ordered to help determine the cause.

What treatment methods are available for delirium?

The health condition or other cause of the delirium must first be established and addressed. Hospitalization is often needed to allow for uninterrupted monitoring of both the delirium itself and the treatment being delivered. Options can include:

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

What things can you do to provide support?

If taking care of the individual with delirium at home, the following tips can help:

  • Reassure the person that everything is alright and that you are right there.
  • Play comforting music that the person enjoys.
  • Provide nutritious meals and make certain the person is drinking plenty of fluids.
  • Engage in conversations together to orient the individual.
  • Motivate the person to remain physically active (in line with the doctor’s guidelines).
  • 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.

Inspired Home Care, an expert provider of home care in Buffalo Grove, IL and the surrounding communities, can be a tremendous help as well for a loved one with delirium. We’re here for as much or as little assistance and support as needed, day or night. Reach out to us at 847-787-7572 for a complimentary in-home consultation to find out more.