When you care for an older person, it’s not always easy to differentiate between different changes in behavior and understand what they mean. This is especially true when it comes to knowing the difference between confusion and dementia. Here are some tips for caregivers to help you know what to do if your loved one shows signs of confusion.

What is the difference between confusion and dementia?

According to the Alzheimer’s Association (ALZ), acute confusion, which is also known as delirium in the medical community, is a medical condition that causes the individual to act confused and experience changes in perception, mood, and behavior. Often, when people with dementia get delirium, the symptoms are mistaken for the normal progression of dementia and not a symptom of another health condition requiring medical attention.

Here are some ways to recognize the difference between confusion and dementia according to ALZ:

  • With dementia, symptoms such as memory loss and changes in intellect progress slowly over a period of months or even years. With confusion or delirium, the symptoms are sudden and abrupt.
  • With dementia, there is a subtle decline, whereas the symptoms of confusion and delirium can change dramatically over the course of the day.
  • The key difference between confusion and dementia is that patients with delirium are completely unable to focus their attention on a single activity or task.

What are the risk factors for acute confusion or delirium?

According to an article in the U.S. National Library of Medicine, at least 20% of people 65 and older hospitalized each year experience complications during hospitalization because of delirium. A higher percentage of those who just had surgery or were admitted to the intensive care unit experience delirium. The article indicates that there are several risk factors contributing to an elderly person developing delirium:

  • The use of catheters or restraints
  • Certain classes of prescription drugs including sedative hypnotics and narcotics
  • Alcohol or drug withdrawal
  • Acute brain conditions such as stroke or intracranial hemorrhage
  • Medical illnesses such as infections. According to the Alzheimer’s Society, urinary tract infections (UTIs) in particular can cause delirium in elderly people
  • Undergoing surgery
  • A change in environment, such as being admitted to the intensive care unit of the hospital
  • Pain and emotional distress.

Other factors that contribute to the risk of delirium include advanced age, chronic renal or hepatic disease, prior history of delirium, and being male.

What should I do if I suspect my loved one has acute confusion or delirium?

The Alzheimer’s Association recommends the following tips for caregivers if someone is showing signs of confusion or delirium:

  • Call your health care provider and let him or her know your loved one is acting especially confused. Be prepared to provide information about any other changes in behavior, such as bowel or bladder changes, and information about all medications, even ones that were recently discontinued.
  • Check for other symptoms such as fever, ankle swelling, difficulty breathing, or evidence of pain.
  • Create a calm, soothing environment for your loved one. Turn down the lights, turn off any TVs or radios in the room, and help him or her get comfortable.
  • Stay with your loved one and speak in reassuring tones. If you need to leave the room, see if a friend or other family member can sit with your loved one and provide reassurance.

Can delirium be prevented?

The Alzheimer’s Association offers the following tips for caregivers in preventing delirium at home:

  • Maintain good health by getting balanced nutrition, staying well hydrated, exercising regularly, and being immunized for pneumonia and flu.
  • Eliminate alcohol.
  • Use sleep medication sparingly; ask your doctor to review any sleep medications and sedatives your loved one takes.
  • Ask your doctor about eliminating or reducing the amount of muscle relaxers, antihistamines, opioids, anti-nausea medications, and centrally acting blood pressure drugs your loved one takes.

Need more tips for caregivers about Medicare plans for a patient who is experiencing confusion or dementia?

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Talk to your doctor before starting any exercise regime to make sure you’re doing activities that are safe for your health and situation.  Also, make sure your doctor approves significant changes in your diet.  This article provides general information, and is not a substitute for medical advice.  Only a licensed medical professional can diagnose and treat medical conditions.