Delirium is a complicated issue that often goes undetected or misunderstood in the elderly. If you’ve begun noticing worrying symptoms or have an older loved one recently diagnosed with delirium, you may wonder how long it will last.
Understanding delirium is crucial for the well-being of older adults and ensuring they receive the right level of care. Today, we’ll explore delirium and its causes, symptoms, and how long it typically lasts.
What Is Delirium?
Delirium is a medical condition characterised by sudden changes in alertness, confusion and cognitive function. It can appear and progress rapidly, often within just a few hours or days, which can be extremely worrying for family members.
Delirium is not a disease itself, but rather a symptom of an underlying medical issue. It can affect people of any age, but is more common and usually more severe in older adults. Delirium requires urgent medical attention.
How Long Does Delirium Last in the Elderly?
How long delirium lasts often depends on the underlying cause, how quickly this can be treated, and individual lifestyle factors. In some cases, issues may resolve within a few days once the underlying cause is addressed. For example, if an infection such as a urinary tract infection (UTI) triggers delirium, symptoms may resolve after a course of antibiotics.
However, this isn’t always the case. Sometimes, delirium symptoms can persist for weeks or even months, especially when complicating factors delay their resolution. Chronic illness and cognitive impairment can contribute to prolonged delirium.
What Are the Common Causes of Delirium in the Elderly?
There are a number of factors that can often contribute to the onset and development of delirium.
These include:
- Infections: Common infections in the elderly can cause a systemic inflammatory response that releases chemicals (cytokines) into the bloodstream, which cross a weakened blood-brain barrier to cause delirium-related symptoms.
- Medication: Certain medications disrupt brain neurotransmitters, leading to sedation or metabolic changes such as dehydration. Common instigators include psychoactive drugs, painkillers (opioids), and sedatives.
- Medical conditions: Dehydration, malnutrition, electrolyte imbalances (low sodium/calcium), stroke and hypoxia are some medical conditions that can trigger delirium.
- Surgery: Older adults are most likely to develop delirium post-procedure, especially those involving general anesthesia.
- Environmental or physical stress: Common triggers of delirium in the elderly include unfamiliar surroundings, pain, sensory impairment (vision/hearing loss) and poor sleep.
- Pre-existing health conditions: Dementia is one of the most common triggers of delirium in older adults.
Symptoms of Delirium in the Elderly
The quickest way to identify delirium in a loved one is to know its symptoms. However, these can vary widely and may overlap with other conditions, making it difficult to spot. Common signs of delirium include:
Fluctuations in Alertness
One of the most common symptoms of delirium in older adults is fluctuating alertness levels. This can manifest in a number of ways, such as hyperactivity followed by sudden drowsiness or lethargy. You may see this as erratic changes in behaviour.
During periods of alertness, your loved one may appear restless, talkative or easily distracted. These bursts are often short-lived and can lead to confusion, disorientation, and difficulty remaining coherent.
Fluctuations in alertness are one of the most common and obvious signs of delirium in the elderly.
Confusion
Confusion is another common feature of delirium, often manifesting as disorientation, cognitive impairment and memory problems. Older adults experiencing delirium might struggle to gauge their surroundings or make sense of what’s happening.
Simple tasks may become challenging, such as following conversations or finding the right words. This can lead to frustration and anxiety, further provoking delirium symptoms.
You may notice your loved one repeating the same question or having difficulty concentrating on tasks at hand. This can indicate confusion and, when paired with other symptoms, can be a concern for underlying delirium.
Hallucinations and Delusions
Delirium can play tricks on the mind, leading to hallucinations and delusions, which can be scary and worrying for individuals affected.
- Hallucinations: Sensory experiences that aren’t based on reality are perceived as truth, such as seeing or hearing things that aren’t real.
- Delusions: Persistent irrational beliefs or thoughts that aren’t influenced by facts, evidence or reasoning.
Hallucinations and delusions can be very distressing, especially when the person experiencing them has a condition that affects cognitive functioning and increases confusion. It can also be difficult for loved ones to witness when they can’t help.
Agitation, Restlessness or Short-Temper
Agitation and anger are common indicators of delirium, especially when your loved one doesn’t typically exhibit these traits. They may react impulsively to their environment or snap at loved ones. Restlessness can look like foot tapping, pacing, fidgeting or the inability to settle or get comfortable.
In some cases, these symptoms can escalate to aggressive behaviour, posing a risk to both you and your loved one. Recognising their agitated state is essential to implementing effective strategies to manage these disturbances and ensure everyone’s safety.
Sleep Disturbances
Delirium can significantly affect sleep quality and patterns, leading to symptoms such as insomnia or daytime drowsiness. People affected may be unable to fall asleep or wake up several times throughout the night. This may make it more difficult for them to remain alert during the day, increasing the risk of daytime naps.
Not getting enough sleep can exacerbate cognitive and behavioural symptoms of delirium, as it can increase the risk of stress, agitation, confusion, alertness and delusions. This creates a cycle of dysfunction for the person experiencing delirium, and can be difficult to break out of.
Learn more with our helpful guide on reducing sleep problems in older adults.
How Can You Manage Delirium Effectively in the Elderly?
The most effective way of managing delirium is to address the underlying cause while providing supportive care to ease symptoms. A treatment plan may include:
Medical Evaluation
Your loved one’s doctor can conduct a comprehensive medical evaluation to find the cause of their delirium. The sooner the cause can be determined, the quicker treatment can occur.
From UTIs to pneumonia, identifying and addressing these underlying triggers is instrumental for effectively managing and resolving delirium.
Medication Review
If your loved one takes several medications, you can ask their doctor to conduct a medication review to determine whether this is the cause of their delirium. They may be able to find alternatives to minimise side effects and, if possible, alleviate delirium altogether.
Nutrition and Hydration Plan
Eating and drinking well can support brain function and overall well-being in older adults with delirium. Dehydration or malnutrition can exacerbate cognitive impairment and trigger symptoms. Your loved one’s healthcare team can assist you with ensuring sufficient fluid intake and a nutritional plan.
Environmental Support
Symptoms of delirium can often be eased with subtle changes to their environment, especially if those changes contributed to its onset. For example, if your loved one has recently moved into a care home and the stress has triggered delirium, looking for alternatives, such as live-in home care, can help.
Aim to create a comforting, familiar setting with minimal stimuli to reduce confusion and agitation. This could involve minimal noise, low lighting, and no other potential triggers.
Family and Carer Involvement
Loved ones can often provide significant support to individuals with delirium, including emotional reassurance and companionship. They can monitor changes and implement practical assistance to lessen the emotional and physical strain of delirium.
A strong support network can help people with delirium receive comforting, comprehensive care that addresses their needs while waiting for symptoms to pass.
How Country Cousins Can Help
At Country Cousins, we take pride in offering comprehensive, compassionate care to our clients. We’ll match your loved one with one of our fully trained, experienced carers to support them with delirium symptoms.
Our live-in carers can:
- Help with daily routines, such as washing and dressing
- Monitor symptoms to ensure they don’t worsen
- Remind individuals when it’s time to take medications
- Plan meals, cook and encourage sufficient hydration
- Maintain the home with light cleaning, laundry and pet care
- Offer companionship and emotional support
Talk to Our Team Today
As the UK’s longest-serving introductory live-in care agency, we have been providing compassionate live-in care to those who need it since 1959 – all from the comfort of their own homes. Give us a call today on 01293 224 706. Our experienced team is on hand to help from Monday to Friday, 9 am to 6 pm. Alternatively, contact us through our online enquiry form.
