For People in Whom Delirium Does Not Resolve:
- Ask doctors to check again for possible causes
- Get an assessment to check if dementia might be present
Supporting Those at Risk of Delirium
Share this helpful information with them, their family and their carers:
- Let them know that delirium is common and usually temporary
- Describe the different ways that delirium can affect people and how it can feel
- Encourage them to tell their healthcare team right away about any sudden changes in behaviour
Supporting Those Who Have Recovered from Delirium
Once recovered from delirium:
- Encourage them to tell their healthcare team about their experience
- Connect them with support groups
Make sure all information is provided in a way they can understand, considering their culture, thinking ability, and preferred language.
How Delirium Differs From Other Conditions
Sundowning Versus Delirium
“Sundowning” refers to behavioural changes that often occur in the evening, typically in people with dementia.
Sundowning may be a regular pattern for people with no obvious medical illness and may be related to circadian rhythm disruptions or environmental factors, such as shift changes, noise, and reduced staffing.
If sundowning is new behaviour, it might be delirium - tell medical staff right away.
Dementia Versus Delirium
Dementia and delirium are sometimes mistaken for each other, but they have key differences in how they progress and how they affect cognitive features.
- In Alzheimer’s disease, cognitive decline is typically gradual, and progressive, and occurs over months or years. Attention remains intact in the early stages, as do remote memories (those from the distant past), and there are fewer fluctuations in memory and cognition.
- Dementia with Lewy bodies (DLB) shares some similarities with Alzheimer’s disease but is often confused with delirium due to fluctuations in cognitive function and visual hallucinations being common and prominent with DLB.
- Delirium typically has a sudden onset, marked by fluctuations in cognition and attention.
Primary Psychiatric Conditions Versus Delirium
- Depression may be misdiagnosed as delirium due to overlapping symptoms like poor sleep and concentration difficulties. Agitated depression - where a person feels restless, anxious, or irritable rather than sluggish or withdrawn and may pace, fidget, have racing thoughts, or feel unable to relax, despite also feeling sad or hopeless- may be even more difficult to differentiate from delirium. However, depression tends to have more consistent symptoms with less fluctuation than delirium.
- Mania can sometimes be mistaken for hyperactive delirium, especially with agitation, delusions, and psychotic behaviour. However, mania often has a history of prior episodes, unlike delirium.