What is Delirium and How Does it Affect Elderly Patients?
Posted by Donna Mae Scheib on June 19, 2017
What is Delirium and How Does it Affect Elderly Patients?
According to Today’s Geriatric Medicine, delirium is a preventable neuropsychiatric syndrome that only has a detection rate of 25% (Kovaleski, 20171). This means that the brain’s ability to send and receive signals becomes affected and in many health care settings, the description of delirium is often downplayed and described as ‘confused’ or a ‘temporary change of mental status due to a certain medicine during hospitalization’. In the United States, after a person has developed delirium, they become more susceptible to the following:
- Higher mortality rates after being discharged from the hospital
- Increased length of hospital stays
- A greater than 60% chance of developing dementia within 2 years of delirious episode
It is easy to label delirium as just another factor of old age and associate it with an elderly patient’s hospital stay because of all of their current health issues. However, the continuing expansion of population of those aged 65 and older makes it important now more than ever for health care professionals to be able to make an accurate assessment of this preventable syndrome.
Definition of Delirium
A medical definition of delirium from Merriam-Webster is “a mental disturbance characterized by confusion, disordered speech, and hallucinations”. It is also defined as an acute disorder which means unlike a chronic disorder or disease, the onset is fast and the symptoms last for only a short time. It is difficult to diagnose delirium because of the many factors that are included, but as time goes on, more tools and assessments are being developed to hopefully lead to standardized documentation; so hopefully, every hospital setting would eventually have an exact procedure to diagnosing delirium.
Common Symptoms of Delirium
As mentioned above, delirium is a fast onset of rapidly occurring symptoms. Most often, it is also fluctuating in nature, which means that many of the symptoms come and go and the elderly patient can go into different types of delirium. The following list includes common symptoms of delirium within a range of overactive symptoms and underactive symptoms:
Over Active Symptoms
- An agitated state
- Restlessness
- Hitting
- Biting
- Need of restraint for safety
- Pulling at medical equipment
Under Active Symptoms
- Lethargic
- Withdrawn
- Apathetic
Common Causes of Delirium
There is a wide range of possible causes that could factor into the onset of a delirious state. This is why this syndrome is not only hard to diagnose but becomes hard to prevent for an elderly patient. The following includes common causes of delirium retrieved from the Mayo Clinic2 that can at the very least help you to be more aware of why an episode has occurred:
- Polypharmacy (the use of many medications at once which is common among the elderly population)
- History of alcohol abuse or current withdrawal, smoking, or depression
- Metabolic imbalance
- Dehydration or malnutrition
- Anesthesia from surgery
- Sleep deprivation
- Severe or terminal illness
Affect in Elderly Patients
It is important to bring these symptoms to light and to call them by a formal diagnosis, delirium. This will help to make it easier for elderly patients to be able to come to terms with the onset of this syndrome. Many patients will try to downplay with what happened or have a hard time recovering from the delirious state as posttraumatic stress disorder may occur after an episode. This can unfortunately lead to more diagnoses of anxiety, depression, and fear of future hospitalizations. Continuing assessment and reassessment to recognize delirium and reduce the onset of the syndrome can:
- Shorten lengths of hospitalization
- Lower rates of injury
- Improved cognitive function
- Lessen complications in general
To learn more information about delirium, it is best to contact your local health care provider and to not come to immediate medical conclusions after reading this article.
1 Delirium Causes. (n.d.). Retrieved from http://www.mayoclinic.org/diseases-conditions/delirium/basics/causes/con-20033982
2 Kovaleski, M. (2017). Detecting Delirium. Today's Geriatric Medicine, 10(2), 13-15.