Delirium and the Elderly

It is fairly common for elderly people to be affected by delirium and/or hallucinations. There may be an altered level of consciousness, inattention or disorganized thinking.

Two of the things you will notice if your elderly parent is suffering from delirium are sudden changes in behavior and their mental state. They may be hyper-alert, startle more easily or be overly sensitive to their surroundings. They can also become quite agitated or may wish to sleep for longer periods of time. They may be unable to follow a conversation or stay focused. Or their conversation may become incoherent. They may also have a decreased appetite or become incontinent. Becoming lost in places they know well is not unusual in this situation. They can experience disturbances in perception such as not understanding what is happening around them. They may not recognize familiar people. There may at times be paranoia or unrealistic fears and possibly emotional outbursts.

My mother, in her last couple of years, had several episodes of delirium and hallucinations. This is very frightening for the person experiencing them and it was also frightening for her family members, especially before we understood the reasons for them. There were several times where she saw people that were not there and carried on conversations with them. She would be adamant that the person existed and became very angry and disoriented when we tried to explain to her what was happening.

Some of the causes of delirium and/or hallucinations are:

- side effects and possible interactions of some medications;
pain;
- infections or severe illness (with my mother it always happened when she had a bladder infection which is extremely common with elderly women);
- oxygen levels;
- lack of sleep;
- effects from anesthetics;
- poor nutrition and/or lack of hydration.

If this should happen to your loved one, it is important that they receive medical treatment as soon as possible. These changes in the person are sudden and are not connected with dementia.

The following are some of the things you can do:

- call the person by name to get their response. Remind them of the day, time and where they are;
- keep sentences short and simple;
- let them know that they are being looked after and are safe;
- if the person wears glasses, make sure they are clean and being worn. This includes their hearing aides as well. These things help them to become orientated;
- try to control excessive noise and over-stimulation. This cannot always be the case, particularly if they are in a hospital environment;
- ensure that dentures are in and that they eat regularly and drink fluids frequently;
- ensure that treatment for the cause of delirium is being treated and followed up on.

Recovery time may vary from days to several weeks or longer depending on the cause of the delirium. Comfort measures are important for the patient as well as having the support of family and friends nearby.