Delirium vs. Dementia: What You Need to Know

In this guide, look at the details of delirium, how it affects people with dementia, and what you can do to support a loved one who might experience both.

What is Delirium?

 
Delirium is a serious health condition where a person experiences a sudden, and often dramatic, negative change in attention, perception, awareness, and cognition.

Symptoms of delirium often develop quickly, but can present themselves over the course of a few days.

Symptoms typically come and go throughout the day, and are often worse at night or when a person is in an unfamiliar setting, like a hospital.

There are three types of delirium:

• Hyperactive delirium. This is the most recognizable type of delirium. Signs of hyperactive delirium include restlessness, agitation, aggression and combativeness; wandering or pacing; inappropriate behavior; and hallucinations.
• Hypoactive delirium. The most common form of delirium, hypoactive delirium is characterized by a person being unusually drowsy or sleepy, having an extremely difficult time paying attention, becoming quiet and withdrawn, or moving slower than usual.
• Mixed delirium. This occurs when someone experiences symptoms of both hyperactive and hypoactive delirium. A person with mixed delirium can quickly switch back and forth from being restless and agitated to sluggish and withdrawn.

Delirium is very common among seniors who need hospital care. More than 30% of people 70 and over experience delirium during their hospital stay.

Delirium vs Dementia— Are They the Same?

 
Delirium and dementia aren’t the same, but they do share similar symptoms, including confusion, disorganized speech, and disrupted sleep patterns. Dementia is also the number one risk factor for developing delirium.

However, there are three key differences between the two:

• Onset. Symptoms of delirium noticeably present themselves within a short period and are temporary, whereas dementia usually begins with small, permanent symptoms of memory loss that slowly get worse over time.
• Attention. Delirium affects the ability to focus and maintain attention, which leads to confusion about day-to-day events, times, places, and sometimes people. However, this confusion and inability to focus isn’t the same as memory loss caused by Alzheimer’s disease or other forms of dementia.
• Changes in symptoms. While those with dementia experience mood swings and have better and worse times of day, their memory and thinking skills typically stay at a consistent and predictable level. Symptoms of delirium rapidly change throughout the day, with some hours of no symptoms.

Lewy body dementia is an exception, because it shares many of the same characteristics of delirium, such as hallucinations and rapid fluctuation of symptoms throughout the day, sometimes over just a few minutes.

While those with dementia experience mood swings and have better and worse times of day, their memory and thinking skills typically stay at a consistent and predictable level.

What Causes Delirium?

 
Medical researchers aren’t clear on what exactly causes delirium, but many believe it has something to do with how your brain and body reacts to stress, injury, illness, and inflammation.

Here are some known causes of delirium:

• A change in medication
• Acute illness
• Dehydration or electrolyte imbalance
• Hospitalization or surgery
• Infections like pneumonia, sepsis and urinary tract infections
• Low blood sugar
• Lack of sleep
• Poor nutrition

Anyone can exhibit delirium, but there are people who are at higher risk. This group can include people with dementia, Parkinson’s disease, chronic liver disease, poor hearing or vision; those with traumatic brain injury or past traumatic brain injury; and people who have had delirium in the past.

How is Delirium Diagnosed and What Is the Treatment?

 
Your loved one’s healthcare provider is the only one who can accurately diagnose delirium, especially if your family member has dementia. Two common measures of delirium are the 4AT test and CAM method.

The 4AT is a quick test that determines your loved one’s alertness, awareness, attention, and acute change in symptoms.

Medical professionals use the CAM method to observe your family member’s behavior and mental state over time. They measure if someone has a difficult time following others as they speak, has trouble organizing their thoughts, or if they’re experiencing an altered state of alertness.

Typically, only severe symptoms of hyperactive delirium are treated with medications. Treating underlying causes, like infection or illness, can decrease or eliminate the symptoms of delirium. Your loved one’s medical provider may order more tests, such as blood tests, MRIs, chest x-rays and bladder imaging, to determine what may be causing their delirium.

Often, symptoms of delirium can often be reduced when a senior has a hospital stay by communicating with the care team about any history of past occurrences. The team at the hospital can take steps to minimize any confusion that might cause delirium, make sure the room is extra quiet, calm and well lit, and avoid medication that increases symptoms.

Tips on How to Care for a Loved One with Dementia or Delirium

 
Support for delirium and. dementia is almost the same, which makes it a little easier for family care partners to provide support for their loved one.

Here are tips from our experts at Oaks Senior Living on how to care for a loved one who has both:

• Read to them, sing to them, or play music they like.
• Encourage and help your loved one with eating and drinking.
• Discourage daytime naps and help them get to sleep at night.
• Keep their environment calm and relaxing.
• If it’s calming to your loved one, encourage other family members to visit.
• Make walking aids accessible and motivate them to move around.
• Make sure they have their glasses or hearing aids, or both.
• Promote cognitive stimulation by talking about the weather or upcoming holidays.
• If your loved one can’t communicate, check for pain by using a pain scale or searching for nonverbal cues.

Even though you love your family member, providing a high-quality life for someone with dementia can be overwhelming. Especially when you’re trying to balance their care, your career, and spending time on yourself and with others.

Memory care in a senior living community can provide your loved one with everything they need for a happy and healthy life. You can focus on enjoying their company and finally find freedom in your schedule to work out, get coffee with a friend, or just spend the day relaxing.

Discover What Makes Memory Care Different at Oaks Senior Living

 
Each memory care neighborhood at an Oaks Senior Living community offers a secure setting with bright and comfortable common areas and a layout that allows residents to easily navigate their environment. Our care team members receive special training on how to help those with memory impairments while offering compassionate, personalized care. Contact Oaks Senior Living online or call us at 770-796-5871 to schedule an in-person visit or ask us questions about memory care. We’re always happy to help!