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Delirium and the Older Person

Did you know?

  • Delirium in the older person is a medical emergency                                                              

  • Delirium occurs in up to 50% of older persons admitted to acute care settings                         

  • Delirium is a sudden change in mental status or confusion                                                           

  • Delirium is not a mental illness

  • Delirium is not the same as dementia                                                                                                  

  • Delirium is a medical condition that causes a temporary problem with mental function

Delirium is a sudden change in mental status, or sudden confusion, which develops over hours to days. Early diagnosis and treatment offer the best chance of recovery.

What does delirium look like?

Delirium is described as an acute change in reasoning. A person with delirium may or may not display all of these symptoms. Symptoms may come and go throughout the day and often increase at night. Some of the common signs and symptoms associated with delirium are:

  • Confusion and or unusual behaviour

  • Paranoia - suspicion of others

  • Delusions or hallucinations

  • Disorientation - being unaware of time and place

  • Reduced ability to concentrate

  • Emotional upset - anxiety is very common

  • Increased restlessness and irritability

What is causing the delirium?

Delirium in an elderly person may be caused by one or many factors. Some of the most common causes for delirium are:

  • Infection (i.e. urinary tract infection or respiratory tract infection)                                            

  • Severe illness (i.e. dehydration or severe diabetes)                                                                             

  • Chronic health problems such as heart failure                                                                                            

  • Post operational (post heart surgery, hip or knee surgery)                                                         

  • Medications (multiple medications, new medication, side effects from medication)

  • Discontinuing drugs (prescribed or recreational) and alcohol

Who gets delirium?

Though delirium can develop in anyone, it is more common in older adults. Delirium is one of the most common and preventable conditions affecting older adults during a hospital stay. Some of the factors that may put people at risk for developing delirium are:

  • Age - especially those who are 80 and older

  • Multiple medications

  • Surgery - especially where an anesthetic was used

  • Hearing and or vision loss

  • Illness

  • Individuals with memory impairment or dementia have an increased risk of developing delirium

How is delirium treated?

The cause(s) of delirium need to be figured out before treatment begins. Health-care professionals will look for underlying causes by doing careful assessments and tests. Despite in depth testing at times causes for delirium are unknown. Generally delirium clears within a few days; however some cases may not clear for weeks or even months. It is also important to note that not everyone who suffers from delirium returns to their usual state.

What you can do to help

It is important for family members to help health-care professionals recognize the signs and symptoms of delirium. Family members know their loved ones best and are able to provide valuable information about changes in behaviour. Some of the things that family members can do for a loved one with delirium are:

  • Be calm and reassuring

  • Encourage proper nutrition and fluid intake

  • Promote physical activity; encourage walking if it is safe to do so

  • Ensure that hearing aids and or glasses are in place if necessary

  • Promote healthy rest and sleep; sleep lights low and reduce noise and distractions

  • Keep track of changes in behaviour

Delirium in older adults often goes unrecognized by health care professionals. Studies have shown that up to 67% of delirium cases were not recognized by physicians and 43% of cases were not recognized by nurses caring for the patients. Delirium is an under recognized but surprisingly common problem.

It is important for you as a family member to talk about changes in your loved one even if no one asks.

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