If an older adult with no history of cognitive impairment suddenly starts having cognitive issues during or after a hospitalization, it is likely not dementia – it could be delirium.
Delirium can cause terrifying hallucinations, delusions, and an inability to think clearly or focus. In older hospital patients, these symptoms can often be misdiagnosed as dementia.
Delirium is a serious condition that adds to the suffering caused by the medical issue that led to hospitalization. Recovery from delirium can sometimes take longer than recovery from the initial medical condition.
Understanding Delirium and Dementia
Delirium and dementia are distinct medical conditions. Dementia develops gradually and progressively worsens over time. In contrast, delirium occurs suddenly and can fluctuate throughout the day. Patients with delirium might be agitated and combative or lethargic and unable to focus.
According to a Kaiser Health News article, delirium affects 7 million hospitalized Americans each year. It can occur at any age, but is more common in patients over 65. Delirium is associated with longer hospital stays, a higher risk of falls, increased likelihood of developing dementia, and a higher mortality rate.
Symptoms and Experiences of Delirium
People with delirium experience cognitive and memory problems, hallucinations, and symptoms similar to post-traumatic stress disorder (PTSD). Common hallucinations include terrifying scenarios, such as being covered in blood or being burned alive. Psychologist James C. Jackson from Vanderbilt’s ICU Recovery Center notes that these distressing experiences are typical.
Delusional memories often distort real events. For example, patients who were catheterized might believe they were sexually assaulted, or those undergoing MRIs might think they were placed in a giant oven.
Causes of Delirium in Hospitals
Delirium is more likely to develop in intensive care patients, especially those who are heavily sedated and on ventilators, with up to an 85% chance of occurrence. It is also common after surgery or due to conditions like urinary tract infections. Once delirium starts, it can persist for months.
Preventing Delirium
Researchers estimate that about 40% of delirium cases are preventable. However, Dr. Sharon Inouye, a geriatric doctor and Harvard Medical School professor, notes that delirium is often under-recognized and under-diagnosed by physicians and nurses. Preventing delirium is crucial since there are still no effective treatments once it occurs.
Delirium can be triggered by treatments that older adults are sensitive to, such as large doses of anti-anxiety drugs and narcotics. Other triggers include busy, noisy, and brightly lit environments where sleep is constantly interrupted, and staff changes frequently.
Strategies to Prevent Delirium in Seniors During Hospitalization
Some hospitals are implementing measures to prevent delirium by carefully managing medications, especially benzodiazepines. They are also working to get ICU patients off breathing machines sooner, limit the use of restraints, and encourage early mobilization.
Additionally, hospitals are creating more pleasant environments by turning off room lights at night, installing large clocks, and minimizing noisy machine alarms. When advocating for an older adult in the hospital, request these modifications to reduce their risk of developing delirium.
Source: Daily Caring
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The post Delirium Is Often Mistaken for Dementia: Know the Signs appeared first on Family Caregivers Online.
