The role of “delirium” in increased confusion


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Delirium is defined as an acute onset of confusion, agitation, and sometimes even hallucinations and restlessness. If you’re a caregiver for someone living with dementia, you’re probably quite familiar with this—even if you didn’t have a name for it!

You’ve probably seen delirium if…

  • You watched someone come back from a hospital stay more confused than when they went in
  • You’ve seen someone start a new medication or stop an old mediation and have bizarre side effects
  • You’ve seen someone with a UTI, urinary tract infection
  • You took a long trip with someone living with dementia, or did something that could be exhausting or quite trying

There are any number of other reasons you might have seen delirium in someone with dementia, although it can actually occur in cognitively-stable individuals, as well. 

I had major eye surgery in 2012 and the doctors put me under anesthesia for about 4-5 hours. When I woke up, I was highly confused. What was I doing there? Why did my eye hurt? Oh, I was so hungry. Was I hungry? I had trouble speaking while the anesthesia wore off, and my memory was a little jumbled. If you’ve ever had surgery, you know exactly what I’m talking about.

Delirium should go away, but it should always be treated when it appears. Don’t just assume that “wow, mom’s dementia is way worse today!” For example, most cases of delirium in older adults with dementia stem from underlying medical conditions, like a urinary tract infection. These are super treatable, and need to be treated quickly, for a person can actually go into shock if it isn’t! 

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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