Delirium - Sudden Confusion or Change in Behavior
For elderly adults who have dementia, feeling confused may be expected. But when the confusion comes on suddenly, or the older adult becomes difficult to arouse, this could be a condition called delirium. This type of sudden confusion may be the first sign that the person has another illness and needs medical help right away.
One myth we often hear about aging is that it’s not unusual to be confused when you’re old. It’s true that we can expect many changes as part of normal aging. But a sudden change in cognitive function—or the way we think and process information—is not one of them.
Even if there has simply been a change in the elder’s thinking or behavior, most caregivers and family members will know that something is not right. It’s important to contact a doctor as soon as possible so that he or she can find the cause of the delirium and treat the underlying problem.
The questions and answers in this section will help you learn more about how to recognize when sudden confusion is an emergency and what you can do about it.
If you notice that an elderly adult has become suddenly confused or is not acting like him/herself, you may need to get help. Signs to watch for include:
- They can’t focus attention or make eye contact.
- You can’t fully wake them up.
- They are mumbling or their speech doesn’t make sense.
- They are seeing or hearing things that aren’t there.
- They have become agitated without any obvious cause.
Behavior like this may be the first sign of a medical emergency called sudden confusion or delirium.
- Elderly adults who have any of these symptoms should see their primary care doctor right away.
- If you notice any of these symptoms in the hospital, tell a staff member immediately.
It’s important to remember that sudden confusion is different than other common changes in thinking that can happen as we age, such as dementia. With dementia, confusion happens slowly over time. With sudden confusion that needs medical treatment, the older adult’s thinking abilities change quickly, often with no warning.
What Should I Do?
Sudden confusion in seniors can be very scary—both for the person who experiences it and the loved ones who witness it. Get medical help as soon as possible, then focus on keeping the older adult safe while they are confused.
People with sudden confusion may focus inward, showing a lack of interest in or attention to the things around them. Or they may become restless and agitated, reacting strongly to things they see, hear, or feel. It is important to remember that feeling confused can be frightening. Do your best to remain calm as you try to figure out the cause of their distress.
Some people with sudden confusion may punch, yell, kick, or act aggressively. That’s why it’s important to focus on keeping the confused person safe until you find out what’s causing their distress. If possible, try to help them walk or change position since this may help ease discomfort.
You may try to gently reorient the person to reality, but remember that their confusion may cause them to see reality in a different way. It will help comfort them to meet them in their world until the confusion is resolved.
Can Delirium be Prevented?
You can take a few simple steps to avoid—or help your loved ones avoid—sudden confusion.
Knowing the risk factors for sudden confusion is the first step. These include:
- Older age
- Sudden confusion in the past
- Multiple medications
- Problems seeing or hearing
- Not getting enough to eat or drink
- Chronic physical illness
- Alcohol or drug use
- Problems in the brain or nervous system
- Functional disability
Important steps you can take to counter these risk factors include:
- Making sure the elderly adult gets enough calories and fluids
- Correcting vision or hearing problems with glasses, hearing aids, or other devices
- Helping ensure the elderly adult has good sleep habits and does not become overly tired or nap excessively during the day
- Trying to involve the elderly adult in activities that challenge the brain, like puzzles, reading, talking about current events, or sharing memories of the past
- Reviewing medications and dosages carefully at each doctor visit and asking questions to help make sure they aren’t given any longer than necessary
Having one or more risk factors makes an elderly adult more likely to develop sudden confusion. But a sudden event such as a severe illness, infection, or fracture is often what disrupts the brain and causes sudden confusion. This type of confusion is a medical emergency. It’s important to identify the cause quickly and to start treatment as soon as possible.
For more information on how to recognize delirium and helpful tips on what to do, see the resources below: