Caregivers Can Help Assess Whether Older Adults are Dealing with Delirium

Journal of the American Geriatrics Society Research Summary

Delirium is a sudden change in mental status that often occurs when older adults are in the hospital or after they have surgery. More than 20 percent of older adults may experience delirium.  The condition can lead to longer hospital stays, the need to be placed on a respirator (a machine that helps you breathe), long-term changes in your cognitive (mental) health, physical disability, and even death.

Acute illness (illnesses that happen suddenly, as opposed to chronic conditions that you live with over a longer period of time), surgery, and medications can contribute to delirium. In addition, disrupting regular routines may trigger sudden confusion or changes in behavior for certain people.

When healthcare professionals don’t recognize or diagnose delirium, it can delay an older person’s recovery.  Prolonged delirium can have a lasting impact on health and well-being. What’s more, delirium is distressing for caregivers—the family or friends involved in caring for an older adult. In hospitals, healthcare professionals screen (“test”) for delirium. However, despite routine screening, more than 60 percent of older adults with delirium are not diagnosed in hospitals. Continue reading

Difficulties Diagnosing Delirium in Older Adults After Surgery

JAGS graphicJournal of the American Geriatrics Society Research Summary

Delirium is a medical term for “sudden confusion.” It is an abrupt, rapid change in mental function and can cause a wide variety of shifts in behavior ranging from aggression or agitation to feeling sleepy and inactive (or even a combination of several behaviors). When delirium occurs after an older person has had surgery, it’s called “post-operative delirium.”

Experts still don’t always agree on delirium symptoms or diagnoses, even when they are assessing the same symptoms in the same people. A team of researchers from the Netherlands designed a study to look at the accuracy of delirium diagnoses in older adults after surgeries. Their study was published in the Journal of the American Geriatrics Society.

In the study, researchers examined 167 older adults from one to three days after surgery. The researchers used a standard delirium rating scale and recorded the tests on video. Afterwards, the videos were shown to two independent delirium experts. If the experts didn’t agree on a diagnosis, the researchers asked a third expert to review the video. A third expert was called in for 21 percent of the evaluations. Continue reading

Dealing with Delirium: Families Share their Stories

If your loved one suffers a bout of delirium, it can be a frightening and unsettling experience for all concerned. Delirium, a sudden change in mental function, can cause an extreme variety of behavioral changes, ranging from aggressive and agitated to sleepy and inactive—sometimes, even a combination of both.

When delirium occurs after an older person has had surgery, it’s called postoperative delirium. It’s good to know that your hospital’s healthcare providers and your family can work together to help manage and improve delirium, as these family caregivers discovered:

“After he had heart surgery, I noticed that my 86-year-old father was confused and not behaving like himself. Based on the delirium prevention information I found on HealthinAging.org, I was able to talk with my family and my father’s healthcare team about the signs of delirium and ways we could help my father feel more oriented in his hospital surroundings. We made sure to have family members around him. We read him the newspaper, got him walking, and kept him engaged as much as possible.

I’m pleased to say his recovery has been remarkable. Had his delirium not been addressed so quickly, I know the outcome could have been very different. As a caregiver, I was thrilled to have reliable health information that guided me in asking the right questions of my father’s healthcare providers.”
– Vivien, A Family Caregiver

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