Older adults are at increased risk for delirium, a serious medical condition with sudden onset that causes fluctuating changes in thinking and behavior. Infections, dehydration, medication effects, poor sleep, surgery and hospitalization are some factors that can lead to delirium. Delirium is a medical emergency.

Being proactive can help prevent a crisis. Family involvement in the care of older adults is key to their health and well-being. Family members know their loved ones best and can promptly notify health care professionals when they notice sudden, unexpected changes in thinking and behavior.

Here are nine steps to help prevent delirium in older adults or keep it from getting worse:

1. Know the signs and symptoms of delirium and seek medical attention at the first sign of the illness. Delirium can occur in response to a seemingly minor illness such as a urinary tract infection or something more serious such as hip surgery. Delirium can happen at home, a facility or the hospital – but is more likely to happen after surgery and/or in the intensive care unit. Delirium is marked by a sudden onset of behavioral changes (over hours rather than days), including:

• Confusion and lack of orientation
• Fluctuating mental state
• Changes in consciousness and attention – including unresponsiveness
• Disorganized or illogical thinking
• Inability to concentrate
• Decreased short-term memory and recall
• Sleeping (a lot or a little)
• Emotional changes, such as irritability, anger or euphoria, not typical for the individual
• Impaired short-term memory and recall
• Changes in perception, including hallucinations
• Alteration in movement patterns – e.g., walking slower, pacing with agitation, picking at the sheets, etc.
• Incontinence

2. Advocate for your loved one. Don’t be afraid to speak up if your loved one is acting out of character or displays any of the symptoms above. In a hospital setting, the staff changes every shift, and your loved one may move between units and floors. The staff won’t know your loved one as well as you do and could assume confusion or other behaviors are due to dementia.
3. Encourage adequate fluids and food. Keeping the body’s metabolism in balance is important in preventing delirium and for treating it, if it occurs. Dehydration can happen quickly in older adults, especially in warm weather. Malnutrition can be a risk factor for delirium.
4. Create a calm, quiet environment for sleeping at night. Use soft lighting. Keep noise levels low. Play soothing music. A good night’s sleep provides rest that sustains the body and promotes recovery from illness or injury.
5. Be aware of medications. Know the medications your loved one takes. Certain medications for mood disorders, allergies, cardiac conditions, pain or Parkinson’s disease can cause delirium in older adults. Be alert for undesirable changes when beginning or changing the dose of a medication. Misuse of drugs, use of multiple drugs (especially during a hospitalization) or withdrawal from alcohol can also result in delirium.
6. Encourage movement and activity during the day. Staying active is good for overall health. Be aware of increased fall risks. Provide enjoyable activities for cognitive stimulation, distraction and comfort.
7. Use simple, clear communication when there is confusion and disorientation. Speak in a calm manner and do not yell or argue. Provide reminders about the day, time, their location or even your name, if necessary. Clocks and calendars offer visual reminders as well.
8. Ensure your loved one can see, hear and chew. Encourage them to wear eyeglasses, hearing aids and dentures while awake. Being able to process the world more accurately through the senses can provide appropriate sensory stimulation and may reduce confusion of delirium.
9. Provide consistent care by family and/or professional caregivers. Have someone nearby who checks in on your loved one’s well-being. Monitor for any health changes, including signs and symptoms of delirium. Keeping an eye on your loved one during after surgery or an unexpected hospitalization can help prevent delirium.

To learn three interventions for delirium, watch our video on “Dementia and Hospital Delirium.”

ComForCare/At Your Side Home Care has experienced, trained caregivers who assist for older adults in their homes. We can provide medication reminders, Meaningful Activities, meal preparation and personal care. We also can offer companionship and a reassuring presence during a hospital stay. Let us help you live your best life possible. Call 800-886-4044 today to learn more.