Delirium
•
Delirium is defined as a temporary confusion
caused by underlying medical problems, drug toxicity or environmental factors.
•
Delirium is a very common, yet often
unrecognized condition in elderly individuals with dementia.
•
It is marked by confusion and disorientation;
fluctuating levels of consciousness; jerking motions; disruption of sleep-wake
cycles; hallucinations, delusions and anxiety; memory impairment and altered
speech; intermittent agitated behavior; mood changes; behavioral problems such
as aggression and wandering; and changes in blood pressure and pulse.
•
Delirium follows a time pattern. It has an
abrupt onset—less than one month; and a short duration—not more than one month
from the time the symptoms are detected to intervention and recovery.
•
Medications are often the major cause of
delirium in the elderly. This results from drug interactions, failure to take
medication, slow absorption of medications, characteristics of the drug itself,
or the use of anesthesia and other medication during and after surgery.
•
Underlying medical problems that may cause
delirium are bladder infection, pneumonia, dehydration, metabolic disorders,
oxygen deficiency, constipation, and urinary retention.
•
Environmental factors may also contribute to
delirium. This ranges from sensory overload, such as too much noise, to sensory
deprivation stemming from isolation, hearing impairment and lack of
environmental stimulation.
•
It is important to identify the risk factors
for delirium and learn about preventative measures. For example, providing
adequate hydration and carefully managing medication are preventative
approaches.
•
Delirium does not involve structural brain
damage.
•
Individuals may completely improve from delirium
if the medical problem is identified and treated.
If
delirium is left untreated, individuals develop additional complications that
may result in poor outcome or death.
What I am learning today makes me worried that I have been making flawed decisions. If dementia patients are made worse by anti-anxiety meds, and sundowning and delirium are caused by over medication and toxicity, then maybe my mother should not be taking these kinds of prescriptions. Yet, her doctor prescribed them based on my descriptions of her behaviors. On the other hand, this same doctor has not yet diagnosed my mother as having dementia or Alzheimer's disease. And, this article states that delirium can also be caused by lack of oxygen and my mother is on oxygen 24/7 because of her IPF symptoms. This is so confusing!
What I am learning today makes me worried that I have been making flawed decisions. If dementia patients are made worse by anti-anxiety meds, and sundowning and delirium are caused by over medication and toxicity, then maybe my mother should not be taking these kinds of prescriptions. Yet, her doctor prescribed them based on my descriptions of her behaviors. On the other hand, this same doctor has not yet diagnosed my mother as having dementia or Alzheimer's disease. And, this article states that delirium can also be caused by lack of oxygen and my mother is on oxygen 24/7 because of her IPF symptoms. This is so confusing!
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