Delirium in the eldery : Understanding it better

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An elderly relative suddenly begins to get confused? You noticed quick changes in his behavior, state of awareness and his memory capacities? Then, it is possible that this senior is affected by delirium syndrome. But how can we recognize it? What are the main causes? And how about the treatment? To answer all these questions, let’s discover more about delirium in seniors.

What is delirium?

Delirium is described as a state of confusion. The symptoms appear suddenly but also tend to resolve quickly. Even if it is temporary, this syndrome can be problematic in seniors’ daily activities. It can affect memory, attention, cause confusion or even disorientation. It is important to ensure that delirium is distinguished from neurodegenerative diseases such as dementiaAlzheimer disease, for example, may be similar in some ways. But it is essential to recognize the differences. 

Delirium is also described in other terms:

  • acute confusional state;
  • confusion;
  • acute brain syndrome;
  • confused mental state;
  • etc.

Causes of delirium in the elderly population

A temporary state of delirium usually has a specific cause. It is then important to identify it as soon as possible to treat the problem properly. Some situations are also considered as risk factors for this acute confusional state.

Risk factors for delirium

Without being direct causes, some risk factors increase the probability of developing delirium. Here are some examples :

  • the age of the person: older adults are more at risk than the younger;
  • hearing or vision problems;
  • comorbidities;
  • dementia or other neurocognitive disorders (like Alzheimer for example);
  • known medical history;
  • etc.

Specific causes that can trigger a delirium syndrome

Some other reasons are identified as more direct potential causes that can lead to delirium in the elderly. 

  • Severe dehydration;
  • New medication or a drug interaction;
  • Recent hospitalization;
  • Post-operative reaction (after surgery);
  • Infection (pneumonia, infected wound, etc.);
  • Metabolic imbalance;
  • Intoxication;
  • Acute illness;
  • Severe pain;
  • etc.

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Diagnosis of delirium for a senior

To confirm a delirium, an evaluation must be made by a health care professional. Doctors, or specialists, will base their opinion on the signs and symptoms. They will also analyze other alternatives and all the differential diagnoses.

Medical diagnosis is based on: 

  • a physical examination;
  • a cognitive evaluation;
  • neurological tests;
  • as well as additional analyses when judged relevant by the physician.

According to the identified reason, the treatment will then be adapted to the cause of the delirium.

How to recognize a senior with delirium symptoms?

Did you notice sudden changes in the way that an elderly loved one is behaving? You may then wonder if this could be caused by a delirium? To properly recognize this acute brain syndrome, it is important to look for the signs and symptoms of this condition.

Symptoms of delirium in seniors

For a person suffering from acute confusion, the signs and symptoms observed are often fluctuating quickly. They may even change within a few hours only. Hopefully, in most cases, they also tend to resolve rapidly.

Being able to recognize the most common symptoms can allow you to help the person suffering from delirium. Here are some of the main manifestations of delirium :

  • altered state of consciousness;
  • difficulty to stay alert;
  • memory problems;
  • behavioral changes;
  • agitation or, at the opposite, slower reactions;
  • difficulties to perform everyday tasks;
  • disorganized thinking;
  • incoherent speech;
  • disorientation in time and place;
  • difficulty to recognize individuals, even family relatives;
  • possibility of visual or auditory hallucinations;
  • disturbed sleep cycle;
  • etc.

Consulting a medical doctor in a situation of acute confusion 

If you notice the apparition of such symptoms, it is important to advise the doctor or the medical team in place. They will be able to investigate the causes to suggest the right treatment. Through a complete clinical examination, health care professionals will be able to distinguish delirium from other neurodegenerative diseases. 

How about the average duration of delirium?

The good news is that this state of confusion is temporary. It can vary from hours to days. The onset is sudden and delirium usually lasts less than 2 weeks. Some cases may last longer but are much rarer.

Dementia or delirium: what are the differences?

At first, it can be difficult to distinguish if an elderly relative is showing signs of delirium or dementia. Indeed, the two problems can be very similar in some ways. In addition, having dementia may also be a predisposing factor for the development of an acute confusional state for some seniors. 

Here are the main characteristics that can help to differentiate them better.

DeliriumDementia
Transitory and reversibleChronic
Usually of short durationGradual development
Sudden onsetProgressive evolution of symptoms
Often associated with some causes or risk factors
Symptoms can fluctuate quickly

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How to help an elderly family member with delirium?

A senior with delirium will require assistance for the duration of their condition. Whether it is through family, a caregiver, hospital staff or home care, the important thing is that the person is well cared for.

The role of family and caregivers: a significant asset

An elderly person in a state of delirium needs to be reassured more than anything else. The presence of close relatives and caregivers is therefore a key factor. If it is possible for a family member or friend to stay with the person, that would be the best scenario. The presence of a close relative is most likely to have a calming effect. In addition, you will be ensuring her safety.

When visiting a relative with delirium, these simple tips can be helpful :

  1. Choose a reassuring tone ;
  2. Remain calm in front of the person ;
  3. Speak slowly ;
  4. Talk about topics that your relative usually likes to discuss about ;
  5. Don’t hesitate to show pictures and to bring back good memories ;
  6. Make the senior feel confident and comfortable.

Whether at home or in a seniors’ residence, visiting your relatives can do a lot of good for them.

The role of the medical team and nursing staff 

If your elderly parent is in a hospital, a long-term care center (CHSLD) or even a seniors’ residence during a delirium episode, the good news is that this person is already being cared for. Have faith in the medical team in place. When needed, make sure to cooperate with them. It is truly in your beloved relative’s best interest.

Even in these environments, visiting your relatives with delirium can be a very good idea. It helps to reduce the stress and reassure the person.

Home care services for seniors with delirium

Another option to provide the best assistance to a senior with delirium is home care services. In the comfort of home, a variety of care is available for elderly people in need of assistance:

  • assistance for meals;
  • hygiene care;
  • mobility and transportation assistance;
  • help with daily tasks;
  • etc.

Personalized home care can be used for both short-term and long-term needs. Caregivers are very dedicated and involved in the well-being of seniors. 

Overall, although delirium in the elderly is a temporary condition, it can represent a challenging time for the senior as well as the family around them. To treat the problem as quickly as possible, it is important to identify the cause. For this reason, do not hesitate to discuss with the doctors and the medical team that is taking care of your relative.

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If you need advice and support through all these steps, know that Visavie is always there for you. Our mission is to ensure the well-being of seniors and their families by supporting them as much as we can. 

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