Delirium

Abstract

Caring for the patient with dementia can be a difficult task requiring a heightened degree of empathy and understanding; however this difficulty can be further exacerbated when the patient experiences episodes of delirium. Care strategies for these two disorders of consciousness and cognition are often very different, and it is extremely important that they are not confounded; indeed when considering them individually, this is quite obvious. However when caring for the person who is experiencing delirium superimposed on dementia, we need an ever delicate approach to provide optimum care. It is vitally important that we do not excuse delirious episodes as part of the dementia process as it important not to diagnose delirium in the place of a deterioration in cognitive status because of dementia. This chapter presents some of the defining characteristics of delirium and differentiates it from dementia as well as identifying some of the precipitating and predisposing factors leading to delirium. It considers the impact and outcomes of delirium and delirium superimposed on dementia (DSD) and also considers some of the pharmacologic and non-pharmacologic management strategies for DSD, as well as interventions for the prevention of delirium.