Dementia and Delirium

Welcome back Careblazer. Today I want to talk about delirium. Another word for this includes encephalopathy. Delirium can be a common side effect for people with dementia and it’s important to understand what it is and how to notice signs of it because it requires medical attention and if not treated can lead to further brain damage.

If you would rather watch the video on this topic, click here.

In this video, I’m going to specifically answer what is delirium, the 3 different types, who gets delirium, the symptoms of delirium, how delirium is diagnosed, if you can fully recover from delirium and what to do if you suspect your loved one has delirium. 

But first, before I get into the video, I have a very important announcement to make. If you are watching this on Sunday, November 15th, it's the very last day I’m accepting new members inside my care course.

It’s my private program where you get to work personally with me and go through private videos and information I don’t share anywhere else. The doors close to that tonight at midnight EST. I can’t keep it open forever because tomorrow, everything is made available and you can start doing the work. I’m excited to work with the many of you who have already joined and I hope you’ll be the next Careblazer to join. I look forward to getting to know more about your situation and caregiving journey. 

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Okay, let’s get started. What exactly is delirium? 

Delirium is increased confusion and reduced understanding of their surroundings that tend to come on quite suddenly and can fluctuate throughout the day. 

There are 3 different types of delirium:  hyperactive, hypoactive, and mixed. Let’s talk about what they are and the symptoms they include. 

Hyperactive delirium is the one that’s most easily recognizable be because it tends to include a significant change in behavior such as increased restlessness, increased agitation, hallucinations in someone who doesn’t usually have hallucinations, They may become combative or resistant to care when they haven’t been before. In this type of delirium, the caregiver is usually able to tell that something is off. Even if your loved one has some challenging behaviors usually, in delirium, they seem to have reached a whole new level and the change has come on quite suddenly. 

Hypoactive delirium is a bit more difficult to notice and it can go missed, especially if your loved one is in a care facility or hospital as hypoactive typically includes symptoms of drowsiness, sluggishness, or appearing to be out in space/in a daze. These symptoms usually mean the person is quiet and not creating much noise or distraction. So in busy care facilities or hospitals, it’s easy for this to go missed. 

Mixed delirium: This includes a combination of hyperactive and hypoactive signs. The person switched back and forth. 

Other symptoms include:  

• An inability to stay focused on a topic or to switch topics
• Getting stuck on an idea rather than responding to questions or conversation
• Being easily distracted 
• Being withdrawn, with little or no activity or little response to the environment
• Poor memory, particularly of recent events
• not knowing where you are or who you are
• Difficulty speaking or recalling words
• Rambling or nonsense speech
• Trouble understanding speech
• Difficulty reading or writing
• Seeing things that don't exist (hallucinations)
• Restlessness, agitation, or combative behavior
• Calling out, moaning, or making other sounds
• Being quiet and withdrawn — especially in older adults
• Slowed movement or lethargy
• Disturbed sleep habits
• Reversal of night-day sleep-wake cycle
• Anxiety, fear, or paranoia
• Depression
• Irritability or anger
• A sense of feeling elated (euphoria)
• Apathy
• Rapid and unpredictable mood shifts
• Personality changes

As you can see, many of the symptoms of delirium are similar to symptoms that can occur in dementia so the main thing for you is to notice if there has been a sudden, quick, shift in any of the behaviors. Perhaps they are happening more often, or more strongly. 

Who can get delirium? 

Anyone can get delirium. People without dementia can get delirium. And people with dementia can get delirium. People with dementia are more prone to getting delirium and It’s a bit more tricky with someone with dementia because the person with dementia may already seem confused and lack understanding about what they are doing, or where they are. So it requires more careful observation when you’re caring for someone with dementia. Otherwise, it may be easy to assume that a new difficult behavior or challenge is related to dementia or a sign of progressing to a new dementia stage. 

That’s also why it’s important for you to be an advocate for your loved one when you take them to the doctor if you suspect it’s delirium. It may be easy for someone to just assume it’s dementia, but you want to clearly relate that the changes appear sudden and dramatic and to encourage a workup for delirium. 

While anyone can get delirium, the people with the following conditions are at most risk: 

• Brain disorders such as dementia, stroke, or Parkinson's disease
• Previous delirium episodes
• Visual or hearing impairment
• The presence of multiple medical problems

What causes delirium?
Many different things can cause delirium. 

• Medications
• Alcohol or drug intoxication
• Metabolic imbalances
• Blood sugar imbalances
• Urinary tract infections
• Dehydration
• Effects of anesthesia
• Malnutrition or dehydration
• Exposure to toxins or poisons

If you suspect your loved one may be delirious, it’s important to get them to a doctor for a workup. Usually, when the underlying issue causing the delirium is addressed, the delirium goes away. But for people with dementia and people with other medical problems, there may not be a full recovery. The person may show an improvement compared to the delirium, but they may not return to their previous level of functioning. 

Careblazer, I hope this video helps you in noticing any signs of a possible delirium iso your loved one can get the care they need as soon as possible. And I truly hope to work with many of you inside my care course. We get started tomorrow. I look forward to getting to know you.