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What causes delirium in people with dementia?

Delirium is a situation where people with dementia become even more confused than usual. They may have trouble walking or standing. They may start wetting themselves. They may become more angry and agitated, and try to strike their caregiver. Or they may become very sleepy and hard to awaken. In some cases, people can experience hallucinations or delusions.

When you see a sudden change in your loved one, think “delirium.” And get them to a provider ASAP to figure out the cause! PEOPLE WITH DEMENTIA ARE AT HIGH RISK FOR DELIRIUM!

Why? A person with dementia is already struggling to think and to move. In my post about crankiness and irritability, I explained how the brain is a lot like an office or business in which half of the workers have been laid off.  When something new shows up that creates another problem, the body has to move resources to handle the problem, stressing the brain cells even more. The result is a temporary and sudden spike in confusion: delirium.

Bladder infections are the usual culprit when it comes to delirium. But colds and the flu can also trigger delirium. So can pneumonia.

Although infections are the usual suspects, other conditions can trigger delirium—especially in people with dementia. Other causes include:

Bottom line: If you suspect delirium, act on your suspicions! Do not accept, “Oh, it is just dementia getting worse.” Take your loved one to their PCP and have them examined. At the very least, check for a bladder infection.

Categories: Caregiving Dementia Help

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Dr. Rita Jablonski

Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.

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