Question

What are three differences between dementia and delirium? Can a client who has dementia also experience delirium? How is the focus of nursing care different for clients who have dementia vs. clients who have delirium?

Answer 1

Dementia is the progressive decline of memory and other thinking skills due to the gradual dysfunction and loss of brain cells. The most common cause of dementia is Alzheimer's disease.

Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment. The start of delirium is usually rapid — within hours or a few days.

Difference between dementia and delirium are as follows:

• Onset. The onset of delirium occurs within a short time, while dementia usually begins with relatively minor symptoms that gradually worsen over time.
• Attention. The ability to stay focused or maintain attention is significantly impaired with delirium. A person in the early stages of dementia remains generally alert.
• Fluctuation. The appearance of delirium symptoms can fluctuate significantly and frequently throughout the day. While people with dementia have better and worse times of day, their memory and thinking skills stay at a fairly constant level during the course of a day.

Dementia and delirium may be particularly difficult to distinguish, and a person may have both. In fact, frequently delirium occurs in people with dementia.

Nursing care for patient with dementia and delirium have some differences.

Nurses play a key role in the recognition of dementia among hospitalized elderly, by assessing for signs during the nursing admission assessment. Interventions for dementia are aimed at promoting patient function and independence for as long as possible. Other important goals include promoting the patient’s safety, independence in self-care activities, reducing anxiety and agitation, improving communication, providing for socialization and intimacy, adequate nutrition and supporting and educating the family caregivers.