It may have happened to a senior loved one, or even to you. In a fairly short period of time, a person changes from being lucid and aware to being confused and agitated. They can’t think clearly or remember where they are or what they’re doing, and they have difficulty recalling even recent events. The symptoms may come on suddenly but then can disappear and reappear. What’s going on? Is this just a normal part of growing older?
Senior Delirium Isn’t Something that “Just Happens”
According to this important article from Next Avenue, the answer is no. What your loved one is probably experiencing is referred to as delirium, and as the article makes clear, it’s a common condition among seniors, one that is both preventable and treatable. “As many as half of hospital patients age 65 and older develop delirium,” writes journalist Edie Grossfield. “Once thought of as something ordinary — something that ‘just happens’ to people as they get older — today, geriatricians and hospitals across the U.S. recognize the dangers of delirium and are increasingly creating programs and protocols to prevent, detect and treat it.”
But for starters, what exactly is this condition called delirium? “Delirium refers to a change in the brain’s neurochemistry that causes a person to become highly confused and unable to think clearly,” Next Avenue writes. “People with delirium often can’t remember recent events or where they are. The condition usually comes on quickly, but the symptoms can come and go.” Delirium can be triggered by a “major disturbance to the body,” such as an infection, chronic illness, the effects of surgery or the beginnings of organ failure. Relatively common illnesses among seniors such as pneumonia or urinary tract infections can be the culprits. Medications are known to bring on delirium in some seniors, as is abuse of alcohol or drugs, but even relatively innocuous triggers such as low levels of common nutrients like sodium or potassium are sometimes to blame. Patients in hospitals and residents of long-term care facilities are particularly at risk.
Senior Delirium: Two Main Types, One Easier to Spot Than the Other
According to the Next Avenue story, there are two primary types of delirium: hyperactive delirium (key symptom: high agitation) and hypoactive delirium (shown by unresponsiveness, lethargy and inactivity). Some seniors can experience both types during the course of an illness. Hypoactive delirium is harder to diagnose because it is much less obvious. “When patients have hyperactive delirium, they’re doing things like shouting at family members or hospital staff, trying to pull out intravenous tubes or even striking out at people,” the article explains. But hypoactive patients “just become really withdrawn and they stop eating [or] stop moving around,” one Mayo Clinic geriatrician told Next Avenue. When a senior becomes apathetic, less alert, and unresponsive, that can indicate the onset of delirium. Both hypoactive and hyperactive delirium are considered equally serious, even deadly, because delirium’s mortality rate is high. Dr. Stephanie Rogers, a geriatrician and physician lead for the University of California San Francisco’s (UCSF) Delirium Reduction program, told reporter Edie Grossfield that the in-hospital death rate for those with delirium is the same as that for heart attack.
“It causes a lot of patient and family distress. There’s been reported cases of post-traumatic stress disorder after hospitalization,” Rogers says. “It increases the likelihood that you’re going to have to go into a nursing home after discharge rather than going home.” Delirium is also associated with patient falls in hospitals, Next Avenue reports, a known cause of injury.
The Best Treatment for Senior Delirium Involves the Human Touch
The best treatment for delirium does not involve drugs, but instead focuses on far more down-to-earth therapies to restore a patient’s health and sense of well-being. Once doctors have dealt with any underlying medical issues such as infection, “treatment for delirium involves making sure the patient is getting the right nutrition, fluids and enough sleep,” says Grossfield. Familiar faces of family and friends will help the patient become reoriented, geriatricians say, and doctors encourage family members to gently remind loved ones where they are and what’s going on with normal family life. Photos and familiar items from home can help.
We also visited the UCSF Delirium Reduction Program website where we found some extremely common sense and helpful tips for families. The site lists several ways to avoid or to deal with delirium, such as:
- Making sure your loved one is wearing the right glasses and hearing aids during the day. When they can’t hear or see well, they can easily become confused and disoriented.
- Helping them stay alert and active by reading with them, playing games, discussing current events, or sharing family news.
- Bringing familiar items from home – photos, music, or a cozy blanket, for example.
- Helping your loved one maintain a good sleep pattern by staying awake during the day and sleeping at night. Nighttime sleep improves immune function and helps the brain recharge. Daytime napping should be minimized.
- Ensuring that they stay well hydrated by keeping water within easy reach.
Is It Senior Delirium or Dementia? Not Always Easy to Tell
The Next Avenue article ends with the tough question: is it delirium or dementia? “The behavior can look similar,” the report states. However, with delirium, the change generally comes on quickly. “Has this been happening within the last few days? Then that tells us it’s more likely we have delirium, as opposed to this is something that’s been going on for months or half a year, and it’s been very gradual,” explained one geriatrician. Also, if the symptoms are linked to another medical issue, such as a new medication or the onset of a health problem, doctors will generally lean toward a diagnosis of delirium, not necessarily dementia.
Put Your Mind at Ease with Proper Retirement Planning from AgingOptions
As people prepare for retirement, most share the same hopes: they want to find a way to protect their assets while avoiding becoming a burden to loved ones, and they want to escape the trap of being forced into institutional care against their will. For nearly two decades Rajiv Nagaich has shown thousands of people how to achieve those goals using a retirement blueprint we call a LifePlan. It’s the only plan we know of that combines all your retirement essentials into one cohesive strategy, so your financial, legal, housing, health and family elements are all working together. We encourage you to find out more at a free LifePlanning Seminar where you’ll have the chance to hear from Rajiv and get many of your questions answered. For a calendar of upcoming dates and times, visit our Live Events page and register online, or call us this week. We’ll look forward to meeting you soon.
(originally reported at www.nextavenue.org)