Delirium is a treatable condition and may co-exist with dementia.
A sudden change in a person’s mental state is known as delirium. Delirium could lead to increased confusion,disorientation or difficulty with concentration, and can come on very quickly.It can occur when you are medically unwell and can be caused by infections,pain, constipation or dehydration. It can have a significant impact on the way a person behaves or functions, especially if they also have dementia. Delirium can be very distressing for the individual and the people who are caring for them.
Delirium is a treatable condition and may co-exist with dementia. However it is sometimes difficult to recognise in people with dementia because it has similar symptoms such as confusion and difficulties with thinking and concentration.
Delirium can last for days, weeks or even months but it may take longer for people with dementia to recover.
In hospitals, approximately 20-30% of older people on medical wards will have delirium and up to 50% of people with dementia. Between 10-50% of people having surgery can develop delirium.
Older people with delirium and dementia have been found to have longer stays in hospital: be at increased risk of complications such as falls, accidents or pressure sores; and be more likely to be admitted to long term care.
There are two types of delirium. People with hyperactive delirium experience increased confusion that fluctuates throughout the day and can feel agitated or restless. People with hypoactive delirium may feel sleepier and be less responsive.
Other symptoms of delirium include: seeing things that are not there or having vivid dreams that are worse at night; difficulty in focusing attention, and problems with following a conversation.
People who have had a delirium say they:
- Felt unsure about their whereabouts
- Worried that other people were trying to harm them
- Felt afraid, irritable, anxious or depressed
- Felt slow and sleepy
- Felt agitated and restless
- Had vivid dreams that continued when they woke up
- Found it hard to follow what was being said
- Found it difficult to speak clearly
- Saw and heard things that were not there
- People with dementia
- People who are dehydrated or have a poor appetite
- People with an infection (although low infection may not show up on tests)
- People who are constipated or have urinary retention
- Older people
- People who have had surgery, particularly hip surgery
- Older people taking multiple medications
- People with sight or hearing difficulties
- People who are nearing the end of their life
- People who are in pain
- People in an unfamiliar or distressing environment
If you have contacted the person’s GP and are awaiting treatment, there are a few things you could do to make the situation easier for them:
- Keep calm and reassure the person
- Use short simple sentences when talking
- Observe the person to see if they are in any pain
- Make sure there is nothing obstructing their senses, and have their glasses and hearing aids to hand if they use them
- Use familiar photos and objects to distract the person and provide familiarity
- Help ground the person by making sure they know the time and date
- Help the person find the toilet if they need it
- Avoid too much stimulation (e.g. turn off the television , ensure there are not too many people in the room)
- Keep a low light on at night
- Avoid disagreeing with the person too much; change the subject if they express ideas that seem odd to you
- Offer them drinks to maintain hydration
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