Dementia and Signs of Delirium: What Caregivers Can Do
If your loved one's sudden mental decline has been diagnosed as delirium, you should get a medical evaluation to look for underlying illness and to help identify the cause or causes of the delirium. But a caregiver's work in treating delirium doesn't end there.
People with dementia and delirium often take days (or sometimes longer) to return to their predelirium mental state. During this recovery time, pay extra attention to three sets of tasks:
Providing supportive care to the person with dementia
Managing any difficult behavior or problematic confusion
Making sure you have the added support you will need during this health challenge
How to provide supportive care for the person with dementia
Every additional physical, mental, and emotional stress will make it a little harder for your loved one's delirium to clear. To help minimize additional stresses, try the following:
Keep your loved one in a reassuring, familiar environment, with familiar caregivers. If your loved one has been hospitalized and is ready to be safely discharged, going to a familiar home may be less stressful than heading for a rehab facility or moving directly into an assisted-living location. If the person can't go home, bring home to him or her in the form of favorite blankets and photos or other homey touches.
Also, avoid a heavy rotation of new caregivers. One to three familiar faces are much less stressful than someone different every day, every shift.
Make sure eyeglasses, hearing aids, dentures, and other assistive devices are always available. Not being able to see, hear, eat, or walk properly is frustrating and stressful. People with dementia often forget to use even those devices they've had for a long time, so they may need to be gently reminded. Note that in the hospital, devices are often removed before procedures or tests; try to make note of the presence of these items throughout the day.
Make sure any pain is adequately treated. Watch your loved one for unarticulated signs of pain, such as wincing, loss of appetite, or favoring one side. Bring concerns to medical staff. Don't worry that your loved one will get "hooked" on pain meds. Untreated pain is a far more realistic concern, since it can actually worsen delirium.
Monitor your loved one for constipation. It may not seem connected to delirium, but it is. Both constipation and dehydration stress the body, and being constipated can be painful.
Keep up your loved one's favorite comfort measures. Everyone has different relaxation triggers. If your loved one seems to respond especially well to a certain kind of music, to massage, to time spent with a pet, and so on, lean heavily on those measures now. Use them frequently through the day.
Make sure the room is a comfortable temperature. It should be neither too cold nor too warm. Cozy socks can feel good in a cool hospital room. Just be sure your loved one doesn't try walking across the floor in them (they're a falling hazard).
