Are They Just Having a “Bad Day” or Is It Delirium?
Knowing the Difference Could Save a Life.
Do you know the difference between a bad day and delirium? At StellarCare NW, we often hear families say things like, “Dad has just been a bit muddled today,” or “Mum seems very sleepy and not making much sense this afternoon.”
When caring for an elderly relative, especially if they already have a diagnosis of dementia, it is easy to write off these sudden changes as just a “bad day” or a natural progression of their condition.
However, our nurse-led training teaches us to view sudden confusion through a different lens. It might not be dementia progression, but possibly delirium.
And understanding the difference is vital! To keep it short:
- Dementia is a slow, progressive decline.
- Delirium is sudden, acute and often a medical emergency.
With that in mind, let’s delve into it further to ensure you have the knowledge to spot the signs early and save a life.
What is Delirium?
Delirium is a sudden change in a person’s mental state. However, this can develop over hours or a couple of days. And it is often caused by an underlying physical issue, such as an infection (like a UTI or chest infection), dehydration, pain or even a reaction to medication.
With delirium, it presents itself in two main ways:
- Hyperactive: The person is agitated, restless, perhaps hallucinating or aggressive. This is easier to spot.
- Hypoactive: The person is unusually sleepy, withdrawn, sluggish and hard to engage. This is much harder to spot and often missed, but just as dangerous.
If missed, the underlying cause (like an infection) gets worse. Thus, leading to hospital admissions, falls and a rapid, long-term decline in health.
So, Why Are We Obsessed with “Soft Signs”
As mentioned, the second way delirium is presented can be hard to spot, and sometimes standard home care often misses hypoactive delirium until it is too late. So, a carer might visit, see the client is sleepy, let them nap and leave.
But because we are nurse-led, we train our team to look for “soft signs” of deterioration.
We don’t just accept sleepiness. We ask: Are they drinking? Is their urine dark? Are they in pain?
We use tools and training to assess changes in their baseline behaviour, as we believe that spotting delirium early means an immediate call to the GP and antibiotics at home. Missing it means an ambulance on potentially the same night.
Introducing CareBoodle: Our Commitment to Innovation
We’re very passionate about solving the problem of missed delirium that we decided to do something bigger about it.
StellarCare NW is incredibly proud that our Managing Director, Stella Shaw, has co-developed CareBoodle, a new digital resource dedicated to helping carers spot these early signs. A collaboration with leading experts, Liz Blacklock and Dr Kirsten Protherough, this tool simplifies complex clinical checks into an easy-to-use format.
Empowering Families
We believe that better knowledge leads to safer care, and we want families in Chester, Ellesmere Port and the surrounding areas in the Northwest and North Wales to feel empowered to question sudden changes in their loved ones.
Don’t just accept that “they are getting old.” If a change is sudden, investigate it.
By combining our nurse-led oversight with innovative tools like CareBoodle, we are working every day to keep our clients safer at home and out of the hospital.
To learn more about the resources we are developing to improve safety in home care, visit the CareBoodle website or get in touch with our team about our proactive approach.