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The Emergency Of Delirium In Seniors

The Emergency of Delirium in Seniors

If you are caring for a senior loved one you may want to know about delirium. It is a medical emergency, yet when it occurs it may be missed as the symptoms can easily be confused with dementia or early onset Alzheimer’s Disease. Here are the important facts about delirium that you need to know.

What is Delirium?

Delirium is the sudden onset of severe confusion, mentally and emotionally. It can happen overnight. The main difference between delirium and dementia is that the confusion comes on suddenly and without warning. The person will have difficulty thinking, paying attention, remembering things and sleeping. If these symptoms occur suddenly and out of the norm for the individual, he or she should receive medical attention immediately. Delirium occurs due to a serious underlying health condition, usually a restriction of oxygen to the brain.

People who are over the age of 65 are more susceptible to delirium, as are people who have suffered a health event that can impact the health of the brain, such as stroke or heart attack. Those who are under extreme emotional stress may be more susceptible to delirium as well.

There are three distinct types of delirium:

  1. Hypoactive delirium: This is the most common type of delirium. Symptoms include being inattentive, sleeping more, feeling drowsy, being disorganized, difficulty completing daily tasks, and missing regular meals or other regularly occurring daily events. People with hypoactive delirium may have difficulty thinking or speaking clearly and may have problems with short term memory. They may also experience problems with muscle control.
  2. Hyperactive delirium: The symptoms of hyperactive delirium are the opposite of hypoactive delirium. The person is very alert but uncooperative, can’t process instructions or comply. Some people may vacillate between hypoactive and hyperactive delirium. This may result in unusual and severe mood swings.
  3. Delirium tremens is a severe form of delirium suffered specifically by people who try to stop drinking.

Causes of Delirium

Any condition that interferes with brain function can cause delirium. These can include:

  • Surgery
  • Pneumonia
  • Asthma
  • Respiratory illness that restricts oxygen to the brain
  • Medications including blood pressure medication, painkillers and sleeping pills
  • Sleep deprivation
  • Dehydration and poor nutrition
  • Infections such as a urinary tract infection

How is Delirium Diagnosed?

A physician will use the Confusion Assessment Method(CAM) and conduct lab and imaging tests to diagnose whether your loved one is suffering from delirium. The CAM test is based on observation of the symptoms and is used to determine the extent of any confusion, difficulty speaking or paying attention, and/or rambling speech.

Lab tests will be conducted to give the physician information on the person’s brain chemistry. Any imbalances in that chemistry can contribute to a state of delirium. Tests can include the following:

  • Blood chemistry test
  • Head scans with CT or MRI
  • Drug and alcohol tests
  • Thyroid tests
  • Liver tests
  • Chest X-ray
  • Urine tests

How is Delirium Treated?

In most cases delirium is treated by treating the underlying cause. For example, if medications are causing the symptoms, then the medications will be changed. If a urinary tract infection or health condition such as asthma is causing the delirium, then treating the underlying health condition usually treats the delirium as well.

It is important to recognize the signs and symptoms of delirium so that it can treated immediately. If the person suffers from dementia, it may be difficult to sort out the symptoms. That is when the factor of time becomes most important. If any senior begins to exhibit different behaviors overnight, there is usually an underlying health factor that needs to be addressed immediately.


If you or your family member is considering in-home care as part of a plan to age in place, contact Family Matters In-Home Care today for a free consultation.  Our team is dedicated to supporting your family and helping older adults enjoy life in the comfort of their own home for as long as possible.

Some of the services offered by Family Matter In-Home Care include: Alzheimer’s & Dementia CareBed & Wheelchair Transfer AssistanceCompanionshipHousekeeping & Meal PreparationPersonal CareRecovery Care, and Transportation.

Carol Pardue-Spears

Carol has worked in the healthcare field for more than forty years. As a Certified Nursing Assistant, she worked for El Camino Hospital in the cardiac unit, Los Gatos Community Hospital, The Women’s Cancer Center in Los Gatos and several home health and hospice agencies. Carol founded Family Matters in 2002 to fill a deficit she witnessed in high-quality, in-home services and care.

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