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Delirium in Elderly Adults: Causes, Signs, Recovery

Delirium can be scary for older adults and for those who care for them. Each individual experiences this altered state of mind differently, and there are a variety of tools to care for these symptoms. In this post, we will answer some of your questions about delirium and the elderly.

What is Delirium in the Elderly?

Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. What that delirium looks like depends on various factors. There are three types of delirium, according to professionals:

  • Hyperactive delirium: Someone with this type of delirium usually feels agitated and restless. They also may refuse to cooperate with medical professionals and experience rapid mood changes and/or hallucinations.

  • Hypoactive delirium: This delirium can include sluggishness, extreme drowsiness, inactivity, and seeming to be in a daze.

  • Mixed delirium: This is a combination of both hyperactive and hypoactive states of delirium.

Hospital delirium in the elderly is also very common, and we will review that more in a later section.

What Are Signs and Symptoms of Delirium in the Elderly?

Below, we will review some signs of delirium. If your loved one develops any of these symptoms, speak to a doctor or nurse immediately.

  • Easily distracted

  • Disorientation

  • Inability to follow conversations or speak clearly

  • Inability to perform routine everyday tasks (i.e., eating)

  • Sudden mood swings

  • Hallucinations

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How Long Does Delirium Last in the Elderly?

Delirium can clear in a few days or a few weeks, depending on how one responds to treatment. However, a patient may experience memory and thought-processing issues permanently. Speak with your healthcare provider if you have any questions or concerns. Later in this post, we will also review some recovery tactics for delirium.

What Are the Causes of Delirium in Elderly People?

No one has pinpointed the exact cause of delirium, but chronic stress, brain inflammation, and imbalances in neurotransmitters all play a role in developing symptoms. Here are a few other things that can cause delirium:

  • Alcohol and drug misuse

  • Certain medications (i.e., sedatives, sleeping pills, blood pressure medications)

  • Sleep deprivation

  • Head trauma

  • Brain tumors

  • Infections (i.e. pneumonia, urinary tract infections)

  • Kidney and liver failure

  • Acetylcholine or dopamine imbalances

What Are Risk Factors for Delirium in the Elderly?

Here are a few risk factors for experiencing delirium:

  • Being over the age of 70

  • Being male

  • Experiencing intense pain

  • Past surgery

  • Anemia

  • Alcohol abuse

  • History of conditions affecting the brain, such as dementia or stroke

  • Functional disabilities

  • Experiencing poor hearing and vision

  • Mild cognitive impairment

What Is Recovery From Delirium in Elderly Adults Like?

Delirium and death in the elderly may be a concern for caregivers. After all, delirium is prevalent during the final 24-48 hours of life. However, it isn’t necessarily a sign of impending death. Many older adults experience delirium while in hospital settings. This type is very common, and medical professionals can miss it. To prevent this type of delirium, it is recommended for your loved one to stay in a hospital with a Hospital Elder Life Program, an Acute Care for Elders unit, or something similar. Other forms of delirium treatment in the elderly include:

  • Address causes and triggers (i.e., stop medications, address metabolic imbalances)

  • Protect the airway

  • Provide fluids and nutrition

  • Encourage regular physical activity

  • Treat pain

  • Address incontinence

  • Encourage involvement from familiar family and friends; do not change providers or living spaces

  • Promote good sleep hygiene (i.e., minimize noise and lighting)

  • Provide eyeglasses and hearing aids

  • Maintain a regular schedule and routine

  • Provide comfort, such as reassuring touches and words of support to keep them calm

However, you should always speak to your doctor directly about any concerns. Be sure to have a list of your loved one’s medications, symptoms and when they started, names and contact information for all healthcare providers, and questions you want to ask.