Identifying Delirium vs Dementia and Choosing Appropriate Interventions

Identifying Delirium vs Dementia and Choosing Appropriate Interventions

by Amanda Barbera, BSN, RN, CSA

Whenever a senior is not thinking clearly, is forgetful or acting out of character, friends, family and caregivers generally assume that the senior may have dementia. Though these symptoms are all common signs of dementia, they are also very typical symptoms of delirium. 

Dementia and delirium appear very similar, with symptoms that include inattention or distraction, disorganized thinking, and behavioral changes such as irritability. The two conditions can be easily confused. It is important to distinguish between the two to ensure that older adults receive the right form of treatment to help resolve or minimize their symptoms.

Dementia and delirium differentiate from one another by their onset and treatment. Simply put, while dementia is a progressive decline in memory, attention, orientation judgment and personality, delirium is the sudden onset of these symptoms. 

Diagnosing Dementia

For seniors who are experiencing the effects of dementia, the onset of symptoms will occur gradually over time. Alzheimer’s Disease, and other related memory disorders cannot be cured or reversed. Instead, there are treatments and medications that can accommodate or reduce its negative impacts. A diagnosis of dementia can only be made by a healthcare provider, and delirium must first be ruled out. However, seniors with dementia do have an increased risk of delirium.

Identifying Delirium in Older Adults

Delirium can have a fluctuating course, and it can be caused by a multitude of factors. These include age, sensory, cognitive and functional deficits, as well as other outside factors. The most common external factors are infection, medications, electrolyte disorders, injury, pain, stress, metabolic issues, disturbed sleep patterns, and unfamiliar environments. Unlike dementia, delirium is often reversible.

To treat and reverse delirium, a healthcare provider or caregiver must identify the causes and then treat them accordingly. For example, if an elder has recently been diagnosed with a urinary tract infection (UTI) and is exhibiting new signs of confusion or other behavioral changes, the infection could be causing the senior’s delirium. Once the senior receives antibiotics, symptoms of delirium should decrease as the infection is treated. Another common cause of delirium in seniors is placement in a new environment, such as a hospital. With unfamiliar surroundings, risk factors, physiological factors, and new medications, an episode of delirium can manifest while the senior is being treated for other conditions in the hospital.

Preventing Delirium

Recognizing risk factors and early interventions can reduce the incidence of delirium. It is estimated that more than half of all cases of delirium are missed and mistaken for dementia or other conditions. Delirium can be prevented by avoiding psychoactive medications, attending regular doctors’ visits as needed, encouraging a quiet and calm environment, using visual and hearing devices as needed and using orientation devices, such as medication reminders and alarms, as needed. In addition, a healthy sleep-wake pattern is also helpful in preventing delirium. Older adults are encouraged to have daytime activity, a light and bright environment during the day, and limited naps throughout the day. In the evening hours, the environment should be dark and quiet to encourage healthy sleeping patterns.

Though dementia and delirium have similar symptoms, they are two distinctive conditions that require very different forms of treatment. If you have a patient who is experiencing delirium or dementia and is in need of additional daily support, Oasis Senior Advisors can help them to find the community or professional assistance that best fits their needs and lifestyle. To contact your local advisor, please call (888) 455-5838.