Dementia

Dementia

Dementia

Dementia is a syndrome characterized by gradually worsening, usually permanent, unlimited cognitive losses — emotional, intellectual, mental, and subjective —due to the gradual breakdown of brain cells. Dementia can show up in many different forms and impact a wide range of normal life activities, including simple, everyday tasks like paying bills, driving a car, shopping, doing laundry, or taking medication.

Dementia is not one solitary condition or disease but an umbrella term that covers multiple conditions like Alzheimer’s, etc. It is diagnosed in a specialist setting, usually by an older-age psychiatrist.

Delirium vs Dementia

People often confuse delirium with dementia. People with dementia can also develop delirium — they can get temporary episodes of acute brain failure. This presents challenges since the two conditions can be somewhat difficult to tell apart when looking at symptoms.

DELIRIUM DEMENTIA
Delirium can be thought of as acute brain failure (sudden). Dementia can be thought of as chronic brain failure (lifelong).
Delirium follows a fluctuating course and is reversible. The symptoms fluctuate enough to be noticeable Dementia keeps progressing and is irreversible. People may experience better or worse times throughout the day, but their cognitive skills and memory recall generally don’t noticeably fluctuate
The onset of delirium occurs in a very short timeframe, and with noticeable symptoms Dementia starts out with symptoms that are not as easily noticed at first, and then they get worse slowly.
Delirium presents significantly greater challenges in relation to maintaining attention or staying focused. Someone just beginning to experience symptoms of dementia would generally still be considered to be alert and able to focus

Dementia is a syndrome characterized by gradually worsening, usually permanent, unlimited cognitive losses — emotional, intellectual, mental, and subjective —due to the gradual breakdown of brain cells. Dementia can show up in many different forms and impact a wide range of normal life activities, including simple, everyday tasks like paying bills, driving a car, shopping, doing laundry, or taking medication.

Dementia is not one solitary condition or disease but an umbrella term that covers multiple conditions like Alzheimer’s, etc. It is diagnosed in a specialist setting, usually by an older-age psychiatrist.

Delirium vs Dementia

People often confuse delirium with dementia. People with dementia can also develop delirium — they can get temporary episodes of acute brain failure. This presents challenges since the two conditions can be somewhat difficult to tell apart when looking at symptoms.

DELIRIUM

  • Delirium can be thought of as acute brain failure (sudden).
  • Delirium follows a fluctuating course and is reversible. The symptoms fluctuate enough to be noticeable.
  • The onset of delirium occurs in a very short timeframe, and with noticeable symptoms.
  • Delirium presents significantly greater challenges in relation to maintaining attention or staying focused.

DEMENTIA

  • Dementia can be thought of as chronic brain failure (lifelong).
  • Dementia keeps progressing and is irreversible. People may experience better or worse times throughout the day, but their cognitive skills and memory recall generally don’t noticeably fluctuate
  • Dementia starts out with symptoms that are not as easily noticed at first, and then they get worse slowly.
  • Someone just beginning to experience symptoms of dementia would generally still be considered to be alert and able to focus.

Symptoms of Dementia:

The clinical features of dementia include:

The symptoms of dementia may present as cognitive or psychological, and the range of symptoms and the potential severity of impact to the individual is far-reaching.

Overall, the clinical features of dementia include:

  • Disintegration of memory – memories, people, places, knowledge
  • Language and verbal problems – understanding, perception, reasoning, and expression
  • Problems with attention, concentration, losing things
  • Problems with decision making, using logic, good judgment, planning
  • Less efficiency with activities of daily living, work duties, and motor skills
  • Behavioral and psychological symptoms – aggression, wandering, depression, anxiety, apathy, low initiative, inappropriate behavior, frequent mood changes
  • Personality and intellectual disintegration
  • Delusions and/or hallucinations, paranoia

Progression of Dementia

The progression seen with dementia is not linear, and the rate of cognitive malfunction, or the severity of the symptoms, may not map to a commonly understood course. Some patients switch between the different stages. Sometimes a behavior like walking off on one’s own may appear in an early stage and later stop or reverse, but something like the impact to one’s memory will likely only worsen.

In loose terms, dementia is a general term for a mild, moderate, or severe decline in cognitive function because of abnormal changes to the brain.

EARLY OR MILD DEMENTIA

Early signs of dementia can easily be dismissed or disregarded as something else deemed less serious. Typically, the signs can be seen as what people think is normal for older people or for those who experience the loss of a loved one or are stressed or anxious. Dementia generally starts with minimal changes in behavior or capabilities, and sometimes the individual’s loved ones don’t want to believe the symptoms could be indicating, but it is progressive and in many cases irreversible.

  • Reduced speed in taking care of mundane work or household tasks
  • Repeating small details or larger components they shared previously in a conversation
  • Trouble remembering the specifics of recent situations or events
  • Losing track of what they were talking about or what the conversation is about
  • Misplacing personal belongings or items at work and redirecting blame for misplaced items
  • Experiencing difficulty comprehending more involved concepts or ideas
  • Reduced capacity to consistently make wise decisions
  • Exhibiting poor money management
  • Increasingly more set in one’s ways and afraid of trying new things, experiences difficulty getting comfortable with change
  • Reduced interest of desire for previously enjoyed pastimes
  • Marked reduction in vitality
  • Increased agitation fueled by failing to complete a task or remember an appointment
  • Increasingly focused on oneself to the point of appearing to be concerned less with others

MILD OR MODERATE DEMENTIA

In this stage, the elements mentioned in the early or mild stage have progressed and have become a greater source of impact and frustration to the individual.
In this stage, it is not uncommon to see some of the following:

  • More repetition during conversations
  • Increased confusion
  • Heightened forgetfulness or confusion when away from the home or settings that are familiar
  • Forgetting people’s names
  • Confusing one person for another
  • Not recognizing certain people
  • Leaving items cooking on the stove or forgetting to light the gas
  • Leaving the house at night in one’s underwear or other inappropriate behavior
  • Having hallucinations
  • Increased likelihood of becoming anxious or angry
  • Forgetting to wash oneself or one’s clothes, as well as cook and/or eat

Depending on the person’s age, severity of their symptoms, how close their immediate family lives, and the extent to which they are willing to provide care, it may be necessary for some to enter a facility to help give the right level of care needed on a daily basis.

LATE OR SEVERE DEMENTIA

In this phase, the impact of dementia has become extremely debilitating for the individual, and their reliance on family members or professionals has increased dramatically.

This phase can often be hallmarked by a complete loss of memory for both recent events as well as of most or all family members, and most details about their life, including their identity. The individual will often retreat into their own world and glaze over as they increasingly experience their inability to communicate, understand anything that is happening around them, or recognize anyone, including those they see all day every day.

Other symptoms of this phase include:

  • Unable to look after oneself in relation to hygiene, eating and drinking, dressing, or using a bathroom
  • Complete inability to recognize anyone
  • Significantly diminished use or understanding of speech
  • Loss of bowel and/or bladder control
  • Unable to identify everyday items like hairbrush, shaver, hairdryer, etc.
  • Asking about relatives who died some years before
  • Sleep issues
  • Issues with swallowing or eating in general
  • Losing most of the strength needed to walk or stand, and likely spending the majority of or all their time in a wheelchair
  • Forgetting from moment to moment if they have eaten, washed, taken medication

Diagnosis of Dementia:

Because of the range of possible manifestations, a doctor will work to identify any pattern in the reduction of cognitive skills and/or motor skills, as well as identify what skills remain intact. Additional assessments can be made through more recent advances with biomarkers — found in the cerebrospinal fluid.

For a complete assessment of the person, the doctor will combine the findings of the person’s medical history, current symptoms, and current physical exam, and (where possible) interview those closest to the patient regarding their observations of the symptoms.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for a dementia diagnosis requires:

  • Numerous cognitive failings evidenced by loss of memory function, inability to acquire new information, and inability to recollect previously acquired information; and any or all of the following:

    1. Impaired language skills (aphasia)
    2. Reduced ability in fine or gross motor skills (apraxia)
    3. Loss of ability to identify objects, but not because of sensory impairment (agnosia)
    4. Executive dysfunction resulting in reduced or loss of ability to organize, solve problems, or make plans
  • The cognitive failings from (1) each present serious deterioration in the individual’s ability to function in their job or socially, and overall, the combined reduction in abilities is pronounced.
  • Presenting symptoms don’t just occur in a delirium.
  • Presenting symptoms are not caused by depression, schizophrenia, or another psychiatric disorder or condition.

Neurological, cognitive, psychiatric, and neuropsychological tests and evaluations will be made in conjunction with lab tests and brain scans to make a determination regarding how the individual measures against these criteria.

Dementia is then either diagnosed as irreversible / pseudo-dementia, or reversible / pseudo-dementia.

Irreversible progressive dementia

Irreversible progressive dementia includes:

  • Alzheimer’s disease
  • Chronic traumatic encephalopathy (CTE)
  • Parkinson’s disease
  • Frontotemporal dementia
  • Creutzfeldt-Jakob disease (CJD)
  • Vascular dementia
  • Lewy body dementia
  • Huntington’s disease
  • Pick’s disease

The impact from irreversible dementia can be seen in permanent or fluctuating changes in personality and behavior.

Causes of Dementia:

Reversible or pseudo-dementia

Reversible or pseudo-dementia can be caused by neurosurgery, neurological infections and inflammations, or metabolic imbalances.

  • Metabolic issues and endocrine irregularity, thyroid issues, diseases like Addison’s, Cushing’s syndrome, Lyme disease, diabetes
  • Insufficient nutrition, vitamin deficiencies such as of B12 and folate, dehydration, chemical imbalances such as too much or too little calcium and sodium
  • Compromised immune system or disorders from infection or immunosuppressive drugs, infections such as HIV and tuberculosis
  • Side effects from medicine
  • Hypoxia or anoxia, sleep disorders like apnea
  • Brain tumors, normal-pressure hydrocephalus, meningitis, intracranial empyema or abscess, swelling in the brain due to viral infections like herpes, traumatic brain injury, subdural hematomas
  • Poisoning, environmental toxins, alcohol and/or drug abuse
  • Heart and lung disease like COPD, high blood pressure
  • Epileptic condition
  • Depression
  • Traumas

Of these, depression is the leading cause of reversible dementia, followed by extreme side effects of medication followed by drug or alcohol abuse. With the right treatment, some of the causes of reversible dementia or dementia-like symptoms can be controlled or reversed.

Risk factors for Dementia:

In addition to the aforementioned causes of reversible or pseudo-dementia, there are multiple factors that can increase an individual’s risk of developing dementia.

These include:

  • Older age – more so for many people above the age of 65. Even still, dementia is not considered normal at any age, and it can present in people well before they hit 65.
  • A family history of dementia – It doesn’t automatically mean someone will get it. In contrast, there are people who develop dementia when there is no family history of the condition.
  • Down’s syndrome – aging combined with the syndrome often results in many developing a form of dementia that is, or is like, Alzheimer’s by middle age.
  • Heavy alcohol use – defined by the National Institute on Alcohol Abuse as consuming 4 or more drinks per day for men, and 3 or more per day for women.
  • Cardiovascular issues – including high cholesterol and blood pressure. These risks can often be reduced with a healthy diet and regular exercise.
  • Untreated depression – risk can be reduced by working with a mental health professional to treat the depression.
  • Obstructive sleep apnea – a treatable condition.
  • Smoking
  • Low educational levels

Dementia Complications:

The potential reach for dementia to impact a person’s quality of life and capacity to function normally is significant due to the potential complications from the cognitive and psychological changes they could experience. The impact of dementia can be very frustrating both for the individual and for their family members, and it can cause serious personal safety outcomes.

Some of the ways the complications can affect a person include:

  • Forgetting to pay bills
  • Not remembering to feed pets
  • Missing appointments
  • Not shopping for groceries
  • Not cooking or eating and ending up malnourished
  • In conversations, repeating the question
  • Telling the same story multiple times
  • Missing deadlines for things like taxes
  • Failing to properly care for personal hygiene
  • Not remembering to wash or change clothes / bedsheets
  • Neglecting general house or lawn maintenance
  • Risk of pneumonia because of difficulties swallowing
  • Infections incurred when the dementia is in a late-stage can result in coma or death

Treatment of Dementia:

A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.

Functional support – from caregivers is crucial so as to maximize mobility and to encourage independence with, for example, washing, toileting, and feeding.

Therapy is an important additional non-drug treatment option for people who may exhibit behavioral issues and symptoms.

Possible therapies include:

  • Streamlining tasks – Goal is to reduce confusion by minimizing the number and complexity of tasks and implement routine where possible.
  • Environmental modification – Goal is to increase a person’s ability to both function and focus by making the living environment quieter and less cluttered. This approach may involve hiding some objects if they are deemed to be a safety hazard.
  • Occupational therapy – Goal is help the individual learn new ways of coping and increase safety within their living space by addressing risks for falls as well as facilitating management of their behavior.
  • Medication – Medication cannot cure dementia but can help to prevent the condition from progressing.

    • Acetylcholinesterase inhibitors – can help by halting the breakdown of the acetylcholine neurotransmitters related to the functions of judgment and memory, which can enhance cognition. These are typically used in treating Alzheimer’s as well as a number of other conditions such as Lewy body dementia and Parkinson’s. These medicines are associated with adverse effects, so patients on these drugs must be closely monitored by a psychiatrist.
    • Memantine – regulates glutamate activity, a neurotransmitter connected to the process of memory and learning. Could be prescribed as part of a treatment plan that also includes cholinesterase inhibitors.

A person’s doctor could also prescribe other medications to address hallucinations, depression, or other conditions.

Provide care for the caregiver

Being a caregiver for someone with delirium can be very tiring, and for some a potential source of anxiety. In order to look after yourself, and to remain able to give the best care, it is important to take care of yourself as well. Consider the following:

  • Joining a caregivers’ support group
  • Developing more understanding about delirium from resources like books, online courses, and other educational materials from agencies, community health clinics, nonprofits, or health care providers. Examples include the National Institute on Aging, the National Family Caregivers Association, etc.
  • Where possible, see if other family members or friends who the individual knows will help in the caregiving so you can have time for yourself.

Symptoms of Dementia:

The clinical features of dementia include:

The symptoms of dementia may present as cognitive or psychological, and the range of symptoms and the potential severity of impact to the individual is far-reaching.

Overall, the clinical features of dementia include:

  • Disintegration of memory – memories, people, places, knowledge
  • Language and verbal problems – understanding, perception, reasoning, and expression
  • Problems with attention, concentration, losing things
  • Problems with decision making, using logic, good judgment, planning
  • Less efficiency with activities of daily living, work duties, and motor skills
  • Behavioral and psychological symptoms – aggression, wandering, depression, anxiety, apathy, low initiative, inappropriate behavior, frequent mood changes
  • Personality and intellectual disintegration
  • Delusions and/or hallucinations, paranoia

Progression of Dementia

The progression seen with dementia is not linear, and the rate of cognitive malfunction, or the severity of the symptoms, may not map to a commonly understood course. Some patients switch between the different stages. Sometimes a behavior like walking off on one’s own may appear in an early stage and later stop or reverse, but something like the impact to one’s memory will likely only worsen.

In loose terms, dementia is a general term for a mild, moderate, or severe decline in cognitive function because of abnormal changes to the brain.

EARLY OR MILD DEMENTIA

Early signs of dementia can easily be dismissed or disregarded as something else deemed less serious. Typically, the signs can be seen as what people think is normal for older people or for those who experience the loss of a loved one or are stressed or anxious. Dementia generally starts with minimal changes in behavior or capabilities, and sometimes the individual’s loved ones don’t want to believe the symptoms could be indicating, but it is progressive and in many cases irreversible.

  • Reduced speed in taking care of mundane work or household tasks
  • Repeating small details or larger components they shared previously in a conversation
  • Trouble remembering the specifics of recent situations or events
  • Losing track of what they were talking about or what the conversation is about
  • Misplacing personal belongings or items at work and redirecting blame for misplaced items
  • Experiencing difficulty comprehending more involved concepts or ideas
  • Reduced capacity to consistently make wise decisions
  • Exhibiting poor money management
  • Increasingly more set in one’s ways and afraid of trying new things, experiences difficulty getting comfortable with change
  • Reduced interest of desire for previously enjoyed pastimes
  • Marked reduction in vitality
  • Increased agitation fueled by failing to complete a task or remember an appointment
  • Increasingly focused on oneself to the point of appearing to be concerned less with others

MILD OR MODERATE DEMENTIA

In this stage, the elements mentioned in the early or mild stage have progressed and have become a greater source of impact and frustration to the individual.
In this stage, it is not uncommon to see some of the following:

  • More repetition during conversations
  • Increased confusion
  • Heightened forgetfulness or confusion when away from the home or settings that are familiar
  • Forgetting people’s names
  • Confusing one person for another
  • Not recognizing certain people
  • Leaving items cooking on the stove or forgetting to light the gas
  • Leaving the house at night in one’s underwear or other inappropriate behavior
  • Having hallucinations
  • Increased likelihood of becoming anxious or angry
  • Forgetting to wash oneself or one’s clothes, as well as cook and/or eat

Depending on the person’s age, severity of their symptoms, how close their immediate family lives, and the extent to which they are willing to provide care, it may be necessary for some to enter a facility to help give the right level of care needed on a daily basis.

LATE OR SEVERE DEMENTIA

In this phase, the impact of dementia has become extremely debilitating for the individual, and their reliance on family members or professionals has increased dramatically.

This phase can often be hallmarked by a complete loss of memory for both recent events as well as of most or all family members, and most details about their life, including their identity. The individual will often retreat into their own world and glaze over as they increasingly experience their inability to communicate, understand anything that is happening around them, or recognize anyone, including those they see all day every day.

Other symptoms of this phase include:

  • Unable to look after oneself in relation to hygiene, eating and drinking, dressing, or using a bathroom
  • Complete inability to recognize anyone
  • Significantly diminished use or understanding of speech
  • Loss of bowel and/or bladder control
  • Unable to identify everyday items like hairbrush, shaver, hairdryer, etc.
  • Asking about relatives who died some years before
  • Sleep issues
  • Issues with swallowing or eating in general
  • Losing most of the strength needed to walk or stand, and likely spending the majority of or all their time in a wheelchair
  • Forgetting from moment to moment if they have eaten, washed, taken medication

Diagnosis of Dementia:

Because of the range of possible manifestations, a doctor will work to identify any pattern in the reduction of cognitive skills and/or motor skills, as well as identify what skills remain intact. Additional assessments can be made through more recent advances with biomarkers — found in the cerebrospinal fluid.

For a complete assessment of the person, the doctor will combine the findings of the person’s medical history, current symptoms, and current physical exam, and (where possible) interview those closest to the patient regarding their observations of the symptoms.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for a dementia diagnosis requires:

  • Numerous cognitive failings evidenced by loss of memory function, inability to acquire new information, and inability to recollect previously acquired information; and any or all of the following:

    1. Impaired language skills (aphasia)
    2. Reduced ability in fine or gross motor skills (apraxia)
    3. Loss of ability to identify objects, but not because of sensory impairment (agnosia)
    4. Executive dysfunction resulting in reduced or loss of ability to organize, solve problems, or make plans
  • The cognitive failings from (1) each present serious deterioration in the individual’s ability to function in their job or socially, and overall, the combined reduction in abilities is pronounced.
  • Presenting symptoms don’t just occur in a delirium.
  • Presenting symptoms are not caused by depression, schizophrenia, or another psychiatric disorder or condition.

Neurological, cognitive, psychiatric, and neuropsychological tests and evaluations will be made in conjunction with lab tests and brain scans to make a determination regarding how the individual measures against these criteria.

Dementia is then either diagnosed as irreversible / pseudo-dementia, or reversible / pseudo-dementia.

Irreversible progressive dementia

Irreversible progressive dementia includes:

  • Alzheimer’s disease
  • Chronic traumatic encephalopathy (CTE)
  • Parkinson’s disease
  • Frontotemporal dementia
  • Creutzfeldt-Jakob disease (CJD)
  • Vascular dementia
  • Lewy body dementia
  • Huntington’s disease
  • Pick’s disease

The impact from irreversible dementia can be seen in permanent or fluctuating changes in personality and behavior.

Causes of Dementia:

Reversible or pseudo-dementia

Reversible or pseudo-dementia can be caused by neurosurgery, neurological infections and inflammations, or metabolic imbalances.

  • Metabolic issues and endocrine irregularity, thyroid issues, diseases like Addison’s, Cushing’s syndrome, Lyme disease, diabetes
  • Insufficient nutrition, vitamin deficiencies such as of B12 and folate, dehydration, chemical imbalances such as too much or too little calcium and sodium
  • Compromised immune system or disorders from infection or immunosuppressive drugs, infections such as HIV and tuberculosis
  • Side effects from medicine
  • Hypoxia or anoxia, sleep disorders like apnea
  • Brain tumors, normal-pressure hydrocephalus, meningitis, intracranial empyema or abscess, swelling in the brain due to viral infections like herpes, traumatic brain injury, subdural hematomas
  • Poisoning, environmental toxins, alcohol and/or drug abuse
  • Heart and lung disease like COPD, high blood pressure
  • Epileptic condition
  • Depression
  • Traumas

Of these, depression is the leading cause of reversible dementia, followed by extreme side effects of medication followed by drug or alcohol abuse. With the right treatment, some of the causes of reversible dementia or dementia-like symptoms can be controlled or reversed.

Risk factors for Dementia:

In addition to the aforementioned causes of reversible or pseudo-dementia, there are multiple factors that can increase an individual’s risk of developing dementia.

These include:

  • Older age – more so for many people above the age of 65. Even still, dementia is not considered normal at any age, and it can present in people well before they hit 65.
  • A family history of dementia – It doesn’t automatically mean someone will get it. In contrast, there are people who develop dementia when there is no family history of the condition.
  • Down’s syndrome – aging combined with the syndrome often results in many developing a form of dementia that is, or is like, Alzheimer’s by middle age.
  • Heavy alcohol use – defined by the National Institute on Alcohol Abuse as consuming 4 or more drinks per day for men, and 3 or more per day for women.
  • Cardiovascular issues – including high cholesterol and blood pressure. These risks can often be reduced with a healthy diet and regular exercise.
  • Untreated depression – risk can be reduced by working with a mental health professional to treat the depression.
  • Obstructive sleep apnea – a treatable condition.
  • Smoking
  • Low educational levels

Dementia Complications:

The potential reach for dementia to impact a person’s quality of life and capacity to function normally is significant due to the potential complications from the cognitive and psychological changes they could experience. The impact of dementia can be very frustrating both for the individual and for their family members, and it can cause serious personal safety outcomes.

Some of the ways the complications can affect a person include:

  • Forgetting to pay bills
  • Not remembering to feed pets
  • Missing appointments
  • Not shopping for groceries
  • Not cooking or eating and ending up malnourished
  • In conversations, repeating the question
  • Telling the same story multiple times
  • Missing deadlines for things like taxes
  • Failing to properly care for personal hygiene
  • Not remembering to wash or change clothes / bedsheets
  • Neglecting general house or lawn maintenance
  • Risk of pneumonia because of difficulties swallowing
  • Infections incurred when the dementia is in a late-stage can result in coma or death

Treatment of Dementia:

A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.

Functional support – from caregivers is crucial so as to maximize mobility and to encourage independence with, for example, washing, toileting, and feeding.

Therapy is an important additional non-drug treatment option for people who may exhibit behavioral issues and symptoms.

Possible therapies include:

  • Streamlining tasks – Goal is to reduce confusion by minimizing the number and complexity of tasks and implement routine where possible.
  • Environmental modification – Goal is to increase a person’s ability to both function and focus by making the living environment quieter and less cluttered. This approach may involve hiding some objects if they are deemed to be a safety hazard.
  • Occupational therapy – Goal is help the individual learn new ways of coping and increase safety within their living space by addressing risks for falls as well as facilitating management of their behavior.
  • Medication – Medication cannot cure dementia but can help to prevent the condition from progressing.

    • Acetylcholinesterase inhibitors – can help by halting the breakdown of the acetylcholine neurotransmitters related to the functions of judgment and memory, which can enhance cognition. These are typically used in treating Alzheimer’s as well as a number of other conditions such as Lewy body dementia and Parkinson’s. These medicines are associated with adverse effects, so patients on these drugs must be closely monitored by a psychiatrist.
    • Memantine – regulates glutamate activity, a neurotransmitter connected to the process of memory and learning. Could be prescribed as part of a treatment plan that also includes cholinesterase inhibitors.

A person’s doctor could also prescribe other medications to address hallucinations, depression, or other conditions.

Provide care for the caregiver

Being a caregiver for someone with delirium can be very tiring, and for some a potential source of anxiety. In order to look after yourself, and to remain able to give the best care, it is important to take care of yourself as well. Consider the following:

  • Joining a caregivers’ support group
  • Developing more understanding about delirium from resources like books, online courses, and other educational materials from agencies, community health clinics, nonprofits, or health care providers. Examples include the National Institute on Aging, the National Family Caregivers Association, etc.
  • Where possible, see if other family members or friends who the individual knows will help in the caregiving so you can have time for yourself.