

Delirium or Dementia - Do you know the difference?

From   http://www.alz.org/norcal/in_my_community_17590.asp from Northern California and Northern Nevada Chapter Home > Delirium or Dementia - Do you know the difference?

What do we mean by delirium?
including changes in perception, attention, mood and activity level.

progression of one’s dementia.



What if you suspect delirium?


unless a patient is experiencing drug withdrawals.

Prevention of Delirium

  Avoid alcohol in any amount.
  Eliminate or reduce the use of the following medications:
  Antihistamines (e.g., diphenhydramine)
  Bladder relaxants
  Intestinal antispasmodic
  Muscle relaxants
  Anticholinergics (drugs with atropine-like effects)
  Opioids (e.g., codeine, hydrocodone, morphine)
  Anti-nausea medication
  Benzodiazepine type sedatives


  Early mobilization after surgery
  (e.g., walking, getting up in a chair)
  Assisting the individual with eating
  Minimizing bladder catheter use
  Avoiding physical restraints
  Avoiding multiple new medications
  Hydration – encourage and assist with fluids
  Providing sensory devices if needed
  (glasses, hearing and visual aides from home)
Overview of Delirium and Dementia
by Juebin Huang, MD, PhD

Delirium (sometimes called acute confusional state) and dementia are the most common causes of cognitive impairment, although affective disorders (eg,
depression) can also disrupt cognition.

Delirium and dementia are separate disorders but are sometimes difficult to distinguish. In both, cognition is disordered; however,
dementia affects mainly memory, and
delirium affects mainly attention

Flaherty JH1, Little MO.


Delirium is associated with several negative outcomes and is not always preventable. Current practices for the management of older hospitalized adults with delirium, such as one-on-one sitters, antipsychotic medications, and physical restraints, have limited effectiveness or potential health risks. 

{snipped} The authors have found that a restraint-free environment can be achieved; "tolerate, anticipate, and don't agitate" (the T-A-DA method) are the core principles of the nonpharmacological approach that go beyond the traditional strategies of management (such as reorientation); based on observational data,