A specialist nurse at Kings College Hospital, London has called for greater awareness of the causes and symptoms of delirium amongst staff caring for older people. Emma Ouldred, a lead Dementia and Delirium (DAD) nurse warns that despite the serious risks it presents, delirium doesn’t receive the same level of attention as dementia but that it’s important for staff to know what can trigger it as well as how to prevent it.
Delirium is defined as an acutely disturbed state of mind characterised by restlessness, delusions and incoherence. For older people or those with dementia, delirium has very poor outcomes, and people with dementia are at particularly high risk of developing the condition. In many cases, the initial symptoms may be hard to spot but those closest to the person may just feel that “something just doesn’t feel right” which can be the first sign to seek specialist advice.
Read on to find out more about delirium and how you can quickly spot the symptoms of this life-threatening condition amongst your high-risk service users.
Delirium can occur with any illness, after surgery, or after commencing new medications. It can develop quickly, in just a few hours or over a number of days. Although it may often be caused by something relatively minor, it can also be an indicator of a serious illness, such as meningitis or pneumonia.
In people with dementia, the effects of delirium can be so severe, that even after a full course of antibiotics, the level of confusion may take some time to recede. In some cases, the sufferer may never return to their previous baseline.
Knowing the potential symptoms of delirium can help your staff to identify the condition quickly and seek medical support to prevent any further deterioration. For those staff caring for people with dementia in particular, an ability to spot when “something just doesn’t feel right” is an essential skill. Any one of the symptoms below could indicate delirium but as a general rule, the more symptoms that are present, the greater the risk.
Safeguard Your Service Users with Dementia by Knowing these 7 Signs of Delirium
- Increased confusion: An unexplained increase in a person’s normal level of confusion or the presence of paranoia could indicate the possibility of an infection leading to potential delirium.
- Variations in alertness or mood: If a person in your care is unusually sleepy or increasingly agitated or unsettled, this could indicate that further monitoring and investigation is required.
- Altered concentration: People living with dementia will often have difficulties concentrating but any significant change in their abilities should be a cause for concern and monitored alongside other symptoms.
- Changes in speech: Any marked deterioration in speech, including slurring, rambling or repetitive speech may indicate a serious underlying problem.
- Behavioural symptoms: Unusual behaviour such as pacing, rocking or aggression could suggest distress, indicating delirium.
- Disturbed sleep patterns: A change in sleep pattern such as being unable to settle, waking unusually early or being restless overnight could be an early sign of physical symptoms which may lead to delirium.
- Hallucinations: Any sign that a person in your care is experiencing unusual visual or auditory hallucinations should act as an immediate cause for concern. In some cases, these may be seen as ‘normal’ for a person with dementia but if they persist or appear to be worsening, always seek medical advice.
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