doctor talking with senior man in hospital bed with his wife

With its similarities to dementia, delirium is often a complicated problem to understand and manage. Older people tend to be at risk of delirium, so our aging care experts have compiled the following insights to help you recognize and respond appropriately in the event that you suspect it in a person you love.

What are the symptoms of delirium?

Much like dementia, delirium symptoms involve disorientation, confusion and other changes in mental status. The important difference, however, is the start of these symptoms. In dementia, there is a slow decrease in cognitive functioning; with delirium, the change is sudden.

There are two kinds of delirium:

  • Hypoactive delirium is the most common type, impacting an estimated ¾ of those with delirium. It can present much like depression, with lethargy and a slowed response time. Other signs include apathy, a flat affect, and withdrawal from social situations or previously enjoyed activities.
  • Hyperactive delirium triggers agitation and restlessness, disorientation, hallucinations, anxiety, rambling, difficulty with concentration, and swift changes in emotion.

It is important to note that both kinds of delirium can happen simultaneously, with the person feeling drowsy and listless one minute followed by feeling alert and agitated the next.

Who is typically subject to delirium?

People at heightened risk for delirium include:

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

What causes delirium?

The primary cause of delirium is often tough to pinpoint, but there are several known contributors:

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

What should you do in the event that you believe a loved one is delirious?

Get in touch with the senior’s doctor immediately for an evaluation. They may perform some simple preliminary tests, such as asking the person to solve a basic 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 determine the cause.

What treatment solutions are available for delirium?

The medical condition or other reason for the delirium should first be determined and addressed. Hospitalization is oftentimes required to allow for ongoing monitoring of both the delirium itself and the treatment being delivered. Options include:

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

What can you do to provide support?

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

  • Reassure the individual that everything is alright and that you’re right there.
  • Play comforting music that the person likes.
  • Provide healthy 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 accordance 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.

Abby Senior Care, a trusted provider of dementia home care in Littleton, CO and 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 required, day or night. Give us a call at 303-699-8840 for a free in-home evaluation to learn more.