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Dementia and Delirium – The Differences and How You Can Help

Introduction

Dementia is a very difficult disease to live with, and it hurts to have to look at your loved one as they slowly stop “being themselves.” Sometimes, it can even seem like they’ve turned into a total stranger overnight, which is why it’s important to be aware of delirium, what causes it, and how it can affect your loved one so that you can help them as best, you can.

Wait, Aren’t Dementia and Delirium the Same Thing?

Dementia and delirium are definitely not the same things, but they can look like the same thing.

I remember being baffled when a doctor first explained delirium to me because he mentioned that it could cause memory problems and confusion.

Now, my grandpa had been struggling to remember things for years by then, and he got confused and disorientated whenever we went to a new place, but in my eyes, nothing had really changed, he had just gotten “worse.” Dementia gets worse over time, surely this was to be expected, right?

Apparently, I was wrong.

See, although delirium pretty much presents in the same way as dementia, there are key differences between the two that aren’t so obvious at first, but which definitely set them apart:

  • Dementia progresses slowly and consistently, while delirium happens quickly and changes throughout the day. Basically, my grandpa slowly losing his memory was dementia, and his waking up one day unable to talk for four hours and then act as if nothing had happened was delirium.
  • Dementia doesn’t affect your consciousness, and my grandpa could go to bed when he wanted and wake up when he wanted. But delirium affects your level of consciousness, which is why my grandpa was suddenly ping-ponging from sleepy to restless throughout the day
  • Dementia doesn’t make you experience hallucinations, delusions, disorganized thinking, and inattentiveness. Delirium does, which explains why my grandpa suddenly thought my grandma was trying to kill him at dinner even though they had spent the entire afternoon together, gardening and watching TV.
  • Dementia isn’t reversible, but delirium is, and thank goodness for that because our family wouldn’t have coped otherwise.

Unlike dementia, delirium at least has a silver lining. If you can figure out what the underlying cause is and treat it, then the delirium goes away!

Don’t be fooled by this silver lining, though. Delirium is very serious because it means that there’s something wrong with your loved one’s health that needs to be solved before it gets worse.

If you’d like to read more about the differences between dementia and delirium, you can check out this article written by Esther Heerema on Very Well Health.com

So, What Causes Delirium?

A lot of things can cause delirium, which is why it’s not only people with dementia who get it. In a nutshell, delirium can be caused by any number of health conditions. I found a really great acronym on The Lecturio Online Medical Library, which shows what the most common ones are:

The reason why people with dementia are more likely to get delirium is that they are more prone to these healthcare conditions. I mean, dementia is in itself a brain injury, after all, and older people aren’t able to fight infections as well as they used to.

(By the way, my grandpa’s delirium was caused by a urinary tract infection, in case you were wondering…)

Here’s How You Can Help

Okay, so your loved one is delirious. Now what?

The first and most important thing that you need to do to help them is to contact their doctor immediately and let them know what’s going on; it’s the only way to find out what’s causing the delirium in the first place. Remember, once you know what’s causing the delirium, then you’ll be able to treat it, and it will go away.

In the meantime, you can do the following to help your loved one through their delirium and recovery:

Do’s

  • Offer them drinks to stay hydrated
  • Keep calm and be reassuring
  • Talk to them using short, simple sentences and a pleasant tone
  • Make sure they are “grounded” and that they know the date and the time
  • You can also keep them grounded by reminding them where they are and by placing familiar photos and objects around them
  • Keep a soft light on at night so that they can see their surroundings and help them get to sleep
  • Always follow delirium guidelines and your doctor’s instructions

Don’ts

  • Moving them around the house/ward will confuse them
  • Assist them to the bathroom and avoid catheterization if you can
  • Only use medication prescribed by a doctor and when necessary.
  • Don’t use sedatives unless your doctor tells you to
  • Only invite a few people over at a time to prevent overstimulation
  • If they need glasses or hearing aids, make sure that they are wearing them.
  • Having obscured senses will make them insecure and worsen their condition

As frustrating as it can be, you need to avoid disagreement and conflict as far as possible. Sometimes the easiest thing you can do when helping your delirious loved one is to simply change the subject and steer clear of what got you arguing in the first place.

Some Food-for-Thought

Now that I’ve explained what delirium is and how you can help your loved one, I’d like to finish off with a reminder that we shouldn’t ever disregard how they feel and what they’re experiencing.

The truth is that we can never understand what it’s like, and I guess that the moral here is that just because they’re acting crazy doesn’t mean they are crazy. It’s scary for us to see our loved ones trying to fight off their delirium, but how scary must it be for them to have to experience it?

There’s always a reason why they act the way we do, and it’s our job to have their back and make sure that we figure out exactly what’s going on.

So, remember, look out for the signs of delirium and contact a doctor the minute you suspect that there’s something wrong. It’s only once the doctor has diagnosed the cause of the delirium that treatment can begin.

Do your best to help your loved one through their delirium and recovery, and you should see improvement in no time.

Howard

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