Dementia or Delirium? Or Both?

Recently we had one of our weekly calls with our Dementia experts at A Mind for All Seasons (AMFAS) the other day. The call included the family of one of our residents.

This particular resident had been acting weird. We had been following the protocol that AMFAS had told us to do.

· She’s been doing regular daily exercise

· She’s eating a carnivore diet (not completely their recommendation but I’m a big fan and so is the family)

· She’s taking supplementation based on her lab work.

· She’s receiving red light therapy practically every day

· She’s doing a sauna almost every day

· She’s sleeping well as far as we can tell

Yet it seemed like her confusion is increasing. When we do these things to others, we see their mental state at least stabilize.

In many cases we see them improve.

At first we thought it was a urinary tract infection. UTI’s are notorious for causing confusion or agitation.

We ruled that out after a UTI test came back negative.

So what gives? AMFAS brought up delirium. The Mayo Clinic defines delirium like this:

“Delirium is a serious change in mental abilities. It results in confused thinking and a lack of awareness of someone's surroundings. The disorder usually comes on fast — within hours or a few days.”

Symptoms of delirium may be:

· Poor thinking skills – Anything from not knowing where they are to rambling speech

· Behavior and emotional changes – personality changes, apathy, depression, anxiety etc.

· Reduced awareness of surroundings – Trouble focusing, easily distracted, becoming stuck on one thing

As you can imagine, people with dementia may make it hard to figure out if those symptoms are dementia or delirium.

The difference seems to be that delirium comes on quickly. Dementia is a slow progression of changes. Also we can fix delirium. Dementia is much harder to treat and most people do not recover.

Delirium is usually the result of an underlying problem. It could be anything from dehydration to medication side effects. Or a deficiency in some nutrient such as magnesium. Or poor sleep.

So we’re ordering more labs for our resident. We may also do a sleep study. Just because she is in bed all night, she may not be sleeping well.

Lack of sleep can be a big contributing factor to delirium.

We’re also going to set her up with a holistic dentist. Infections in your mouth can contribute to both dementia and delirium. Either way it would be good for us to take her.

Her family told us the resident does not have a good dental history. That includes root canals and lots of cavities.

As you can imagine the resident has quite a sweet tooth.

It’s time to put on our detective hats and see if we can find the underlying cause. As we try to figure it out, I will try to keep you updated.