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Haims: Understanding the difference of delirium and dementia

If you are starting to notice cognitive changes in your parents or aging loved ones, you might want to educate yourself on the differences between delirium and dementia.

As our county ages, a paradigm shift of our senior education and care needs to occur. We need to be educated on the many health/illness signs that afflict our aging loved ones. This is a huge undertaking and often an overwhelming task as most of us are not medically trained and the signs of medical concerns can be complicated and confusing even to our trusted medical providers.

Unfortunately, for those of us in the throes of caring for our aging loved ones, our knowledge of how to best help is limited. Therefore, those of us who are experiencing anxiety because of our limited experience and medical education, need to arm ourselves with resources that can educate us with good questions to ask.



When is a change in behavior delirium and not part of dementia?

Per the Alzheimer’s Association, “Dementia is not a single disease; it’s an overall term — like heart disease — that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. In dementia, changes in memory and intellect are slowly evident over months or years.“



Delirium is a worsening or change in a person’s mental state that happens suddenly, over one to two days. The person may become confused, or be more confused than usual. Or they may become sleepy and drowsy. Delirium can be distressing to the person and those around them, especially when they don’t know what’s causing these changes.Delirium may be the first sign that someone is becoming unwell, and is one of the most common early symptoms of coronavirus infection in people with dementia.”

So, how do we learn what to ask?

Step one is to develop a team. In addition to asking questions of friends and medical professionals, there are many local and national organizations that can help put you in the right direction.

Locally, there are several social workers that can help (call our Visiting Angels office to ask for contact numbers). In Eagle County, we are fortunate enough to have a very proactive Eagle County Healthy Aging program who can be called for guidance (970-328-8896). Nationally, social workers can be found at the National Association of Social Workers (800-742-4089). Both organizations can assist in facilitating a family meeting and help develop a care plan and/or deal with family dissension.

What is delirium?

Delirium is a state of worse-than usual mental confusion, brought on by some type of unusual stress on the body or mind. While dementia progresses rather slowly and over a period of time, symptoms of delirium usually begin over a few hours or a few days.

Delirium is a common clinical syndrome characterized by inattention and cognitive dysfunction. Unfortunately, people with Parkinson’s disease are at high risk for developing delirium as are those of our loved ones who are frequenting intensive care units, emergency rooms, assisted living facilities, and physical rehabilitation units.

Signs of delirium onset include:

  • An inability to stay focused on a topic or to switch topics
  • Getting stuck on an idea rather than responding to questions or conversation
  • Being easily distracted by unimportant things
  • Seeing things that don’t exist (hallucinations)
  • Restlessness, agitation or combative behavior
  • Calling out, moaning or making other sounds
  • Being quiet and withdrawn — especially in older adults
  • Slowed movement or lethargy
  • Disturbed sleep habits

ICU, delirium Is a growing problem

According to the ICU Delirium and Cognitive Impairment Study Group at Vanderbilt University School of Medicine in Nashville, the number of patients experiencing delirium each year is on the rise and is becoming an increasing problem because, more than ever before, more patients are being treated in the ICU.

Professor Eugene Wesley Ely, a critical care specialist who led the study Group, notes that as many as three out of four ICU patients experience delirium, and the proportion is even higher among patients using a ventilator to help them breathe.

Delirium is sometimes misunderstood, even among health care providers. In general, if you want to care for your aging loved ones with a high level of efficacy, you must be hands-on. Without proper collaboration with someone on the ground, it’s simply not possible to care for your loved ones long-distance.

Delirium is a condition effecting many people. It is a prolific problem that can be detected and mitigated with the help of family, love ones, and caregivers.

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He can be contacted at http://www.visitingangels.com/comtns or at 970-328-5526.


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