Detecting delirium can be difficult because it tends to come and go, and conditions like dementia can make symptoms harder to recognize. Yet, in dementia care, early diagnosis and management of delirium are crucial. If left untreated, delirium can lead to a lasting decline in thinking abilities and overall health.
The prevalence of delirium ranges from 1–2% in the general community to as high as 35% in palliative care and up to 70% among individuals living in long-term care (LTC) facilities. Unfortunately, many cases go undetected, undiagnosed, and untreated.
Among individuals with dementia, the risk of missing delirium is especially high because both conditions share similar symptoms, such as confusion, disorientation, and agitation. The relationship is also “bidirectional.” Dementia increases the risk of delirium, and delirium can accelerate cognitive decline in those already living with dementia.
So, what exactly is delirium, and why is it considered a medical emergency? The Mayo Clinic defines delirium as “a serious change in mental abilities that results in confused thinking and a lack of awareness of one’s surroundings.” It usually develops quickly, within hours or a few days.
Delirium is a medical emergency. The underlying cause, such as pain, dehydration, infection, or metabolic imbalance, requires immediate medical assessment and treatment.
Types and Signs of Delirium:
· Hypoactive Delirium: Often appears as unusual sleepiness or excessive fatigue. The person may seem withdrawn, quiet, or less responsive than usual.
· Hyperactive Delirium: Presents as restlessness, agitation, aggression, or hallucinations. This can be especially difficult to recognize in people with Lewy Body Dementia, who often experience hallucinations as part of their condition.
· Mixed Delirium: Alternates between hypoactive and hyperactive symptoms. The person may appear lethargic at times, then suddenly agitated or restless.
When someone with dementia shows off-baseline behaviour, delirium should always be considered. Remember, delirium is treatable once identified, but it requires urgent medical attention.
Can Someone with Dementia Also Experience Delirium?
Yes. When a person living with dementia displays agitation, uncooperative behaviour, or aggression, it is not always due to dementia itself. This misunderstanding is one reason delirium often goes undiagnosed.
Diagnosing and treating delirium promptly is essential, especially for those with dementia. If someone you care for shows new or worsening confusion, agitation, or lethargy, consult a healthcare professional right away.
Treating the underlying cause may resolve the symptoms completely. Caring for someone living with dementia requires attention, teamwork, and open communication among everyone involved in their care. Since delirium is treatable, becoming skilled at recognizing it can prevent unnecessary suffering and help maintain quality of life for those who cannot always speak for themselves.
Karen Tyrell CPCA, CDCP is a Dementia Consultant, Educator, Author & Advocate, and Founder of Personalized Dementia Solutions Inc. (www.DementiaSolutions.ca). Karen offers her expertise on dementia care through speaking engagements; workshops; support groups (both online and in-person) and by working one-on-one with families/caregivers to provide emotional support and practical solutions. She was also on the design team for The Village Langley (Verve Senior Living) and provides ongoing education to the Village team, families and the community. If you would like to learn more, please feel free to reach out.DISCLAIMER:The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
Ref:
https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386
