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Many of us have heard of dementia. Dementia refers not a particular disease, but to a general decline in cognitive functioning such that a person’s ability to think, remember things, make decisions, and reason is impaired. Dementia occurs when this decline interferes with someone’s day to day life and activities.

You may not have heard of delirium however. Delirium is different from dementia in several ways. First, we’ll start by discuss what delirium actually is.

What is delirium?

Delirium is not a disease, but rather is an altered mental state. Unlike dementia, which is chronic, delirium refers to “sudden confusion” and affects attention.  While dementia is long-term, and gets worse slowly over time, delirium is acute and occurs when a person’s mental status suddenly changes over the course of a day or two. Delirium can be a sign that someone is not well and can be a symptom of Covid-19 in people who have dementia.

There are different types of delirium:

  • Hyperactive delirium occurs when a person becomes overactive.
  • Hypoactive delirium occurs when a person becomes underactive and is most common.
  • Mixed delirium is a combination of hyperactive and hypoactive delirium.

What Causes Delirium?

Delirium has different causes which can include:

  • Side effects of medications or drug toxicity
  • Hormonal problems
  • Failure, illness, or injury of the kidney or liver
  • Dehydration or malnutrition
  • Changes to a person’s environment
  • Infection or illness including urinary tract infections, flu, pneumonia, or sepsis
  • Drug or alcohol intoxication, overdose, or withdrawal
  • Hospitalization or surgical procedures
  • Other medical procedures involving anesthesia
  • Sleep deprivation
  • Metabolic imbalance, like low calcium or sodium
  • Fever or pain
  • Medical conditions, including injury from a fall, stroke, or heart attack

What are Symptoms of Delirium?

Symptoms of delirium include a combination of cognitive impairments, changes to behavior, or emotional disturbances. Symptoms include:

  • Memory problems or difficulty concentrating
  • Disorientation
  • Trouble speaking or remembering words
  • Speech that rambles or is nonsense
  • Being withdrawn
  • Difficulty understanding speech
  • Trouble with reading or writing
  • Hallucinations
  • Restlessness
  • Agitation, irritability, anger, or combative behavior
  • Lethargy, laziness, or slowness
  • Upset sleep habits
  • Anxiety, paranoia, or fear
  • Depression or apathy
  • Swift and unpredictable mood or emotional changes
  • Euphoria
  • Shifts to a person’s personality

Who Experiences Delirium?

Delirium is more common in older adults and persons who are in a hospital or nursing home. Approximately ten to thirty percent of hospitalized patients experience what is known as hospital delirium. People who are under stress, who recently had surgery, or are at the end of their lives are at higher risk of developing delirium. In addition, people in intensive care units are more likely to experience delirium. Having HIV, Parkinson’s disease, chronic liver disease, or cancer increases a person’s risk of having delirium. People with multiple illness or chronic conditions who require multiple medications are also more likely to develop delirium.

Additional risk factors for developing delirium include being on dialysis, dehydration, lack of sleep, and burns. People who cannot move because they have a catheter or are in some way restrained are at higher risk of experiencing delirium. Withdrawal from drugs or alcohol also increases the likelihood of delirium. Finally, having a stroke, having trouble seeing or hearing are risk factors.

How Can You Help Someone Experiencing Delirium?

It is important that individuals experiencing delirium receive treatment because delirium can hinder a person’s recovery from other illness or ailment. Delirium that is untreated and prolonged can have a negative and lasting impact on an older adult’s health and general welfare.

If you notice a loved one suffering from symptoms of delirium, stay with that person and provide comfort. Make sure they eat and drink. You can also make sure that your loved one can access their eyeglasses, hearing aids, or dentures, if need be. Sharing a list of someone’s medications and dosages with healthcare providers can assist those provides in recognizing and treating delirium. In addition, let healthcare providers know about an older person’s health issues, including allergies.

You can help the person remember where they are and why they are there. Doing things to make that person feel more familiar and at home can also help. For example, bringing familiar objects like a family photo can help with this. Engaging in conversation or encouraging physical activity and playing games or other simple pastimes that a person likes can be beneficial for someone experiencing delirium.

Learn More About Delirium