Delirium. Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning.
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2 Delirium Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning. DELIRIUM IS A MEDICAL EMERGENCY!
3 Delirium: Hallmark Features Inattention- inability to sustain focus Perseveration- unable to appropriately shift attention
4 Terms and Definitions Delusion- A false belief. Hallucination- Seeing or hearing what is not in the environment. Illusion- When an object seems to appear to be something different than what it is.
5 Delirium: Types Hyperactive delirium- very active, repetitive behaviors, wandering, hallucinations and may have verbal or physical outbursts. Hypoactive delirium- characterised by reduced arousal, lethargy and drowsiness. Mixed delirium- a fluctuation between hyperactive delirium and hypoactive delirium.
6 Case Scenario Joe is 80, he has dementia and lives at home with his wife Margaret Margaret is trying to give Joe his medication and says Joe, it is time to take your meds Joe is looks very drowsy, is not making eye contact He looks sad and distracted and does not answer
7 Delirium: Risk Factors A person over the age of 65 Mild Cognitive Impairment, Dementia Prior delirium History of falls
8 Recent surgery Delirium: Risk Factors Change of an already present chronic illness Dehydration Malnourishment
9 Sleep deprivation Delirium: Risk Factors Withdrawal of drugs or alcohol
10 Prevention Strategies Gain knowledge about delirium Use caution with medications Manage chronic pain Treat infections early
11 Delirium: Causes Infection ( bladder or pneumonia) Medication side effects Improper administration of medications
12 Delirium: Causes Alcohol or medication withdrawal Falls Hospitalization
13 Delirium: Signs and Symptoms Inattention Disturbance of memory Disorientation and disorganized thinking Disturbance to sleep-wake cycle
14 Delirium: Signs and Symptoms Restless or very sleepy Altered perceptions (delusions, hallucinations, illusions) Emotional disturbance ( physical or verbally reactive)
15 Delirium versus Dementia Delirium is a sudden onset of mental confusion as a result of a underlying medical condition (Reversible) Dementia is a progressive change in cognitive functioning as a result of progressive degeneration of brain cells (Non-Reversible)
16 Delirium versus Dementia Onset Duration Attention span Psychomotor activity Mood Psychotic features Delirium Sudden (days or hours) Usually short, days to weeks Decreased Increased or decreased Normal to anxious Hallucinations Visual Tactile Dementia Months to years Usually slowly over years Normal Usually normal or decreased Normal can have apathy Paranoid delusions Hallucination (visual, not often)
17 Caregiver Approach Provide a calm reassurance to the person Ensure the person s pain is managed Provide a calm, quiet environment Orientate the person as often as possible
18 How families can help: Care Strategies Healthy rest and sleep: Reduce noise and distractions Adjust lighting Increase comfort
19 How families can help: Care Strategies Physical Activity Help the person with walking and sitting Discuss with your health professional safe physical activities
20 How families can help: Care Strategies Hydration and healthy eating Help with eating Offer fluids often
21 How families can help: Care Strategies Healthy Hearing: Ensure person has their hearing aides and that they are working properly
22 How families can help: Care Strategies Healthy Vision: If the person has glasses, ensure they are wearing them and that they are clean Provide good lighting Have a magnifying glass present
23 How families can help: Care Strategies Mental stimulation: Socialization Current events and surroundings Reading- use larger print
24 Delirium: Treatment Your Health Professional will: Find and treat the underlying cause of the delirium Do a medication review Give fluid by intravenous Give medications that calm the person with delirium
25 Questions?
26
27 Delirium: Fast Facts It is a Medical Emergency! Sudden onset Inattention: Inability to maintain focus Perseveration: Unable to shift focus
28 Dora Diamond First Link Manager Alzheimer Society of Manitoba Phone:
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