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How to Support a Senior with Delirium

Suppose you’ve noticed an elderly loved one seeming disoriented, distracted, confused, and unable to think clearly. That older adult could be suffering from a condition known as delirium.

Delirium can be caused by many factors and the effects are, in most cases, reversible. The risk of contracting delirium increases for people more than 65 years old or hospitalized for illness or surgery. Delirium has been known to affect a third of hospital patients aged 65 and over. 70% of intensive care patients in that age group experience delirium.

That’s why families and caregivers need to understand what delirium is so they can play a role in its prevention, detection, and management with love, compassion, and support.

What is delirium?

Delirium is a condition that causes noticeable changes in the way someone thinks and acts. They may seem confused or mentally scattered, and often appear detached from the world around them. 

The condition is often an outward sign of something going wrong on the inside, such as a reaction to medications or simple dehydration. The fogginess someone feels for days after undergoing a surgery that required anesthesia – can also be classified as delirium.

People with delirium can be aware of what’s happening to them, becoming distressed because they cannot determine the cause or pull themselves out of the delirious state. If they’re confused, they put themselves at a higher risk for falls and injuries.  

However, not all people with delirium seem outwardly agitated. Hypoactive delirium refers to when the person is much quieter, seemingly distant, and off in “another world”. This makes this type of delirium harder to spot.  

In any case, untreated delirium can lead to adverse outcomes over time, such as a loss of independence or accelerated cognitive decline.

Possible signs of delirium 

It can be frightening when someone we care about suddenly acts confused or upset for seemingly unexplainable reasons. Not knowing what to do or how to react can add to an already stressful situation.

Symptoms of delirium can come without warning and last from anywhere between a few hours to several days. Some of the more common signs of this condition are:

  • State of confusion, paranoia, or restlessness
  • Seeming upset, troubled, or unfocused
  • Forgetfulness 
  • Lack of focus
  • Not making sense when they speak
  • Drowsiness
  • Acting more alert than usual
  • Having signs of depression
  • Hallucinating
  • Mixing up their days and nights
  • Not knowing where they are

If the person is in the hospital when they develop delirium, the hospital staff might not recognize the symptoms. That’s because they don’t know your loved one as well as you do and might mistake the symptoms for normal behaviour. 

In any case, when you notice these behavioural changes, seek medical attention for the person as soon as possible. 

Is there a difference between delirium and dementia?

Although some of the symptoms of delirium can be confused with the signs of dementia, the two conditions are entirely different. 

People with dementia can suffer from delirium as part of the disease because delirium reflects the illness or toxins in the brain that causes dementia. However, delirium alone won’t result in dementia.

Dementia, a blanket term for brain diseases including Alzheimer’s disease, is a degenerative loss of memory and cognitive skills. It starts slowly and gets worse over time. We can do some things to slow the progression of dementia-like conditions, but there is no cure, and the symptoms will worsen.

Unlike dementia, delirium occurs suddenly. It’s often the only outward sign of a severe medical problem that can eliminate the symptoms of delirium if diagnosed and treated correctly.

How do you treat delirium?

The first step to treating delirium is seeing the doctor at the first signs of the condition. The doctor will take an inventory of the person’s medical history, such as previous illnesses, treatments, and other factors. They may also perform a series of tests to determine what’s at the root of the delirium condition. These tests can include blood tests, brain imaging, and electrocardiograms.

Some of the more common causes of delirium include:

  • Infection
  • Recent surgery that required anesthesia 
  • Side effects of medications or a change in medication
  • Dehydration or poor nutrition
  • A chronic illness that’s progressing
  • Low or high blood sugar
  • Low vitamin B1
  • Withdrawal from medications for relaxation
  • Low or high levels of sodium, potassium, calcium, or magnesium in their blood
  • Dehydration 
  • Constipation 
  • Inability to urinate 
  • Pain
  • Excessive alcohol consumption, or suddenly ceasing to drink alcohol
  • Withdrawal from relaxation-inducing medications 

Treatment for delirium will vary depending on which cause triggered the condition. The doctor may prescribe medication to help the person relax if they’re agitated or upset. Family or caregivers can make adjustments to the person’s living space if it allows them to remain calm, or stay in the hospital room with them for reassurance.

Supporting someone who has delirium

Family members and caregivers can help reduce the stress of delirium in older adults with a calm and soothing approach, such as:

  • Keeping their living space quiet and serene
  • Encouraging them to rest and sleep
  • Ensuring they’re up during the day, even if just sitting up in a comfortable chair 
  • Helping them with preparing healthy, nutritious meals
  • Making sure they drink plenty of liquids
  • Validate their feelings, using empathy to feel what they feel
  • Reading a favourite book or letters/emails to them
  • Engaging in light, pleasant conversation
  • Playing music they enjoy
  • Keeping their glasses handy and hearing aids on
  • Encouraging friends and family to visit
  • Bringing personal items from home if the person is in the hospital

You might also consider hiring an eldercare specialist who can sit with the person and assist them with tasks such as eating, bathing, and personal care. They can also keep them engaged with tasks or activities the older adult enjoys.

Family and caregivers providing supportive care can go a long way to helping the elderly loved one’s brain and body recover. It’s the best way to get them back to enjoying life on their terms.If you have any questions about our professional in-home eldercare services that help the older adult in your life manage or recover from illness or injury, please get in touch with our team anytime.

About the Author

Michael Lu is the founder of CareHop, specializing in providing compassionate support for individuals and families touched by Alzheimer’s disease and dementia.

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