When seniors become confused, the first reaction of those around them is often to assume they have early dementia or the onset of Alzheimer’s. However, the issue may well be delirium, a condition seldom recognized by caregivers.
In fact, it’s not easy to differentiate between delirium and dementia, both of which have similar symptoms, including:
- Feeling irritable and possibly aggressive
- Experiencing reduced focus and ability to think coherently
- Issues with memory or recall
- Difficulty with problem-solving
Because of these similarities, caregivers are not always tuned into the assistance the senior requires to become more functional.
The reason for the confusion between dementia and delirium
Delirium and dementia are both common causes of cognitive impairment in seniors. Both involve mental confusion and may affect up to 50% of seniors over 60.
While the initial symptoms are similar, treatment differs vastly, and it’s important for caregivers to know which of these two conditions is predominantly presenting in order to obtain suitable treatment.
Correct diagnosis matters
Studies by Dementia.org show that around 50% of delirium cases are misdiagnosed as dementia—by both caregivers and medical professionals. If delirium is not correctly diagnosed, the senior may be denied valuable treatments that may alleviate the condition.
Frequently, delirium originates from the long-term intake of prescription drugs or alcohol. Therefore, any medical intervention must be adjusted to the state of delirium, and strict monitoring is required. If delirium is mistaken for dementia, incorrect (or too much) medication may be applied, which may aggravate the condition and stifle any sense of recovery.
Dementia, however, is a major neurocognitive disorder—a brain condition that falls within a large spectrum of symptoms, causes and results. It’s incurable and gradually worsens as the senior advances in age, but according to The National Institute on Aging, only around 30% of people older than 82 may develop this disease. Dementia may be managed by certain medications and cognitive and physical interventions, and is usually caused by brain injury or disease, or genetics. When symptoms surface, it’s vital to seek medical intervention as soon as possible. Medical tests such as lab testing or imaging can help to identify and manage this condition.
If you’re caring for an older adult, use this symptom chart to help you determine if the senior is exhibiting signs of delirium or dementia:
|Swift onset: Delirium typically displays very quickly, and the onset is very fast, sometimes within a day or two.|
Hallucinations: The older adult will see things that aren’t there or hear noises that don’t exist.
Irritability: The senior will exhibit aggression, an unwillingness to participate, defensiveness and/or agitation.
Insomnia: The senior finds it difficult to sleep.
Apathy: They are unable to identify with others or have empathy.
Memory impairment: They cannot remember recent or past events or names of loved ones.
Speech difficulties: They have slurred or disorganized speech, and a difficulty remaining on one topic.
Confusion: The senior confuses names, situations, conversations and times of day.
Disorientation: They seem to not know people, time, location, or what’s going on around them.
|Slow onset: Often dementia takes months or years to progress to the point where it can be diagnosed.|
Memory loss: Often recent or distant events cannot be recalled, such as dates of birth, meal times, or where they live.
Speech difficulties: They begin slurring, not being able to say words within a normal sentence, and often use strange words to refer to familiar objects.
Reading and writing challenges: They are unable to physically write or understand what they are reading.
Repeating questions: They often ask the same questions within minutes even after receiving clear answers.
Balance problems: They experience frequent falls and are unable to hold balance.
Loss of interest in life: They often lose all interest in activities they used to enjoy.
Hallucinations: They are seeing invisible people or objects.
Impulsivity: They begin acting out of character: going for unsupervised walks or performing tasks that are dangerous on impulse.
How caregivers can help
First, it’s essential to recognize the difference between delirium and dementia, as both conditions require vastly different treatments. Some suggestions:
- Immediate reaction: If there’s any change in the cognitive responses, seek help immediately. It’s vital to diagnose these conditions as soon as possible to provide the best care possible.
- Staying connected: Check in often and ensure the senior’s health is good. If you are a part-time caregiver or loved one, ensure constant contact to notice any changes in behavior, reaction or absences. Ensure someone close can check in on them if you cannot make contact.
- Reliable medical resources: Ensure a doctor or other medical professional is able to assist as soon as possible if something goes wrong. Pre-program numbers of doctors, ambulance and other resources as a priority in case these are needed in a hurry.
- Company: Provide regular company for stimulation and conversation.
- Diet: Ensure your loved one’s diet is suitable and they’re eating nutritional meals. Discourage destructive behaviour such as too much alcohol, sugar or fat intake.
- Aid during recovery: A care facility may be needed. If a loved one or caregiver no longer feels capable of managing the situation, it may be time to seek care assistance facilities. Even during a stay at a facility, it’s still vital that regular contact is kept and that the senior or loved one is not feeling alone and neglected.
- Proper equipment and medical supplies: Often wheelchairs, adult diapers, special bathing equipment and nutritional supplements are required, so ensure all are available.
- Hygiene: Often people with cognitive difficulties lose interest in hygiene, so make sure to assist with daily needs and that bedding remains clean.