What is Delirium?

January 15, 2024
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It is important that health and social care professionals are able to recognise the presence of delirium and provide effective care for individuals grappling with this complex mental state.

In this article, we will define what delirium is and how it differs from dementia in the elderly, explore the challenges it creates for those suffering from delirium, list the common symptoms and causes and provide guidance on caring for people with delirium.

What is Delirium in the Elderly?

Delirium is more than a fleeting confusion; it is a rapid and profound decline in mental clarity, usually occurring over one to two days. This condition is often a response to various medical issues, making it imperative for healthcare providers to identify and address the underlying problems.

Individuals at risk typically face multiple medical challenges simultaneously, heightening the urgency for proactive care. By understanding the nature of delirium, professionals can tailor their approach to the specific needs of each affected individual.

Symptoms of Delirium

Recognising delirium demands a keen understanding of its varied symptoms. Beyond the commonly observed traits, such as heightened distractibility, reduced awareness of surroundings and confusion, individuals may also exhibit difficulties performing routine tasks or tasks they were previously able to complete with ease.

Furthermore, infections, particularly UTIs, are common culprits in triggering sudden confusion associated with delirium. To deepen your understanding, refer to our article on Urinary Tract Infections in the Elderly, which explores the correlation between infections and delirium, offering valuable insights for healthcare practitioners.

Difference Between Dementia and Delirium

Understanding the disparities between dementia and delirium is crucial for healthcare professionals working in care. While both dementia and delirium can coexist and may share some common symptoms, understanding the differences in their nature and causes is important for accurate diagnosis and tailored care. Dementia is a chronic, progressive condition, while delirium is an acute, reversible state often linked to specific medical issues. 

Onset and Duration

Dementia: Typically, dementia has a gradual onset and progresses over an extended period. It is a chronic condition that involves a decline in cognitive abilities, memory loss, and changes in behaviour. The effects are persistent and may worsen over time.

Delirium: In contrast, delirium manifests suddenly, often within hours or days. It is an acute state of confusion with rapid onset and tends to fluctuate throughout the day. Delirium is usually reversible when the underlying cause is identified and addressed.

Cognitive Impairment

Dementia: Cognitive impairment in dementia is persistent and often includes memory loss, language difficulties, and challenges in problem-solving. The decline is gradual and may not be related to a specific medical event.

Delirium: Cognitive impairment in delirium is characterised by fluctuating attention, disorientation, and confusion. It is usually reversible and linked to an underlying medical condition or environmental factors.

Fluctuation in Symptoms

Dementia: Symptoms typically remain relatively stable over time, with gradual progression. Day-to-day variations are minimal.

Delirium Symptoms can fluctuate throughout the day, often worsening at night. The individual may experience periods of clarity followed by increased confusion.

Underlying Causes

Dementia: The primary cause of dementia is neurodegenerative, such as Alzheimer’s disease, vascular dementia, or other progressive brain disorders. An acute medical issue does not typically trigger it.

Delirium: Often a response to an acute medical problem or multiple medical issues occurring simultaneously. Common triggers include infections, medication side effects, metabolic imbalances, or surgery.

Reversibility

Dementia: Dementia is generally irreversible, with treatment focusing on symptom management and support to enhance quality of life.

Delirium: Delirium is often reversible when the underlying cause is identified and addressed promptly. Effective management of the triggering factors can lead to a full recovery.

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Need a Training Course?

Our Health and Social Care courses, notably Dementia Awareness, provide targeted training to equip professionals with the knowledge needed to achieve a more accurate diagnosis and tailored care plan for individuals with either condition.

How to Help Someone with Delirium

Providing effective care for delirium involves a multifaceted approach. Identifying and treating the underlying cause is paramount, as delirium often improves with targeted interventions. Delirium usually lasts for one to two days, and creating a supportive and calm environment is crucial to facilitating the individual’s recovery process.

Alzheimers.uk lists some tips on how to help support the wellbeing of those with delirium, these include:

  • Ensuring they are wearing any hearing aids and glasses they may have.
  • Providing a 24-hour clock and calendar that is easily visible.
  • Encouraging a good sleep routine. Reducing noise and dimming lights at night where possible.
  • Reassuring the person if they have delusions and/or hallucinations.
  • Helping and encouraging the person to be as active as is safe and appropriate.
  • Helping them to regularly drink and eat.
  • Refraining from moving the person unnecessarily – either within and between hospital wards or into the hospital if delirium is being managed at home.

Exploring relevant research findings is essential for those seeking insights into the duration of delirium. Additionally, our articles on effective communication and active participation offer practical guidance, aiding professionals in reassuring and supporting individuals during their recovery from delirium.

By understanding the nuances of delirium, healthcare professionals can enhance their ability to recognise, understand, and respond effectively to this often misunderstood condition, ultimately contributing to improved outcomes and quality of life for those under their care.

Further Resources: 

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Safeguarding Adults