Delirium

Delirium is largely poorly recognised and misunderstood by clinicians and non health professionals alike.
But as the prevalence and awareness of dementia increases, so too does the recognition and understanding of what delirium is.

Is dementia the same as delirium?
No.

Is delirium a worsening of dementia?
No.

So what is delirium?

Delirium is an acute confusional state.
Acute meaning that the onset is recent.
One that develops over hours or days and the symptoms tend to fluctuate throughout the day.

People who have dementia have a pre existing vulnerability to developing a delirium.
This being the case, it is therefore important, in my view anyway, that families are aware of delirium and if it should occur in their loved one with dementia, then the family are aware the delirium is the delirium, that it is not a worsening of the dementia itself.

Delirium does resolve.

In my day to day work, when I’m working in the hospital, I often see a carer bringing their loved one with dementia to the hospital, describing symptoms of delirium but believing the increased confusion, agitation and sometimes challenging associated behaviour is the dementia worsening.
The conversation from the carer then tends to take the course of something like ‘I can’t do this anymore, this dementia is so bad I can’t take ‘loved one’ home. I will have to look into nursing home placement’.
At this point what is needed is reassurance and support!
The person with dementia/delirium will likely be admitted to hospital for investigations and probable treatment for the underlying cause of the delirium.

The delirium should resolve.
It may take days or weeks, but gradually the confusion and agitation should subside.
However, in some instances where the delirium is so bad, the person’s dementia may become worse too.
This happened with my Dad and was the tipping point at which he received his diagnosis of dementia.