July 13, 2014

Delirium

Another new discovery from the Alzheimer's Foundation of America:


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!

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