Long-Term Care

The effect of delirium on the elderly

LTC Nursing Assistant Trainer, October 20, 2011

Delirium is often mistaken for dementia. Delirium is best described as an acute state of confusion. In contrast, mental confusion caused by dementia is "chronic" confusion. Residents who are alert suddenly or progressively become more confused with delirium. When delirium manifests itself in residents with dementia, personnel notice a worsening of confusion, and the resident may be more lethargic than usual. Residents with a history of dementia and impaired renal or cardiopulmonary function are at increased risk. Residents over age 75 are also considered at high risk.

Some residents develop a condition called chronic delirium. A common symptom is lack of awareness of the environment or the inability to correctly interpret environmental stimuli through the senses. In many cases, the resident's vision or hearing require correction. Inability to see or hear well causes the resident to be unable to interpret the environment correctly. Many residents become dependent on staff members for care because of unrecognized, uncorrected vision problems. They may respond inappropriately because of a hearing deficit. In severe cases, uncorrected sensory problems may cause delusions, hallucinations, and misinterpretation of noise and images. If sensory problems are suspected, keep the environment quiet, well-lit, and familiar. Keeping routines and personnel consistent also helps maintain the resident’s mental status. Strive to identify and correct the underlying cause. Work with the social worker to schedule the resident for hearing or vision examinations.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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