This week’s Q & A call was about how to better manage health and healthcare issues, when you’re taking care of someone with a dementia such as Alzheimer’s.
Most of the caregivers’ questions were about delirium. This is the state of worse-than-usual confusion that people can develop when they are sick or under serious stress.
I love talking to Alzheimer’s caregivers about delirium, because this is a really common problem that family caregivers absolutely can do something about!
The key is to know that people with dementia are especially prone to get delirium when they fall ill (especially in the hospital). And then you’ll want to know the basics on how to spot this problem, and how to get the doctors to address it properly.
A fact I wish more caregivers of elders knew: delirium can be the only obvious sign of a potentially serious health problem, such as a heart attack, a urinary tract infection, or a pneumonia. (Especially when it comes to older people with Alzheimer’s, they often don’t voice focused complaints the way younger people do.)
The trouble is, even though delirium is very common in older adults, studies have shown that it’s often missed by doctors and nurses. This is a important problem in healthcare, for three key reasons:
- Delirium is a sign of something being wrong with the body, or the person. Whether it’s a life-threatening infection or just too much sleep-deprivation in the hospital, it’s important to identify and reverse the delirium triggers as quickly as possible.
- People are at risk for injury while delirious. People who are delirious are more likely to fall. They are often restrained in the hospital to keep them from pulling out IVs (although being tied up can cause greater stress and worsen the delirium). Delirium has been linked to longer hospital stays, and worse healthcare outcomes.
- Delirium can cause permanent declines in mental abilities. As I explain in this post, titled “A common problem that speeds Alzheimer’s decline,” studies have found that after delirium, some people never recover all the way back to their previous abilities. Research has also suggested that delirium episodes can speed up cognitive decline overall.
I really believe it’s important to think beyond eating blueberries to slow down brain decline. In my mind, preventing delirium and promptly trying to treat it are actually more likely to protect an older person from harm.
How you can learn to prevent, recognize, and treat delirium
Preventing delirium: Now, it’s not possible to prevent all cases of delirium. But there are things that YOU can do, to reduce the chance of a bad delirium. Try these resources:
- “FAQ: Can Delirium be Prevented?” an article I wrote for Caring.com
- “For Older Adults & Caregivers“, from the Hospital Elder Life Program
Recognizing delirium: To learn to spot delirium in someone with a dementia such as Alzheimers, try these:
- FAQ: What Is Delirium, and What Causes It?
- How to Spot Signs of Delirium in Someone With Dementia
- FAQ: Are Delusions a Sign of Dementia, Delirium, or Both?
What to do about delirium: For more on what to do if you suspect delirum, and to make sure your loved one gets the right work-up:
- What to Do if You Suspect Delirium
- FAQ: What Should I Do if I Think My Loved One Is Having Delirium in the Hospital?
- What Doctors Should Evaluate When Someone With Dementia Becomes Delirious (I’m bolding this checklist as it’s one of my favorites!)
- Dementia and Signs of Delirium: What Caregivers Can Do
- FAQ: How Is Delirium Treated?
What to expect after delirium: Even when all the right things are done — including getting the person home to a restful familiar environment — it often still takes a while for delirium to get better. In fact, it’s pretty common for it to take weeks, or even months, for delirium to completely resolve in an older adult. (I once had a 90 year-old patient slowly get better over a whole year!) For more info:
If your loved one has had delirium in the past, the most important thing to know is that he or she will be at high risk of developing it in the future. So, be sure to review the resources above on preventing delirium, and on spotting it quickly if it comes up.
You can also visit Caring.com’s Dementia and Delirium Solution Center, which I helped create back in 2011. I hope this information will help you feel more prepared and informed as a family caregiver.
Have you had any experiences with delirium? Please share any stories or questions below in the comments!