Is It Dementia or Delirium?

It seems that I’m seeing the word delirium all over the place. Um, could that mean that I’m having some – issues? Well, perhaps. I prefer to say that it’s because I’ve been researching this sometimes tragic result of hospitalization, especially with elders, and it’s been on my mind a lot.

 

Jane E. Allen wrote a piece for the Los Angeles Times, dated October 20, 2003. The reason I’m quoting this piece is that it is so thorough, without being obtuse and difficult to digest. Her piece is titled “Delirium takes a toll in the ICU” and I found it on the Global Action on Aging site. There are many other studies and papers, but for our purposes, Ms. Allen’s piece seems very suitable.

 

When my dad had brain surgery to drain fluid that was building up in his brain due to a World War II brain injury, he went into surgery kind of fuzzy because of the fluid, but came out totally demented. His nurse, whose name was Brad (as was my father’s), was a wonderful young man and he and Dad got along famously – before surgery.

 

After surgery, Dad kept pulling me aside and telling me to get him out of there, because Brad had tried to kill him in the shower, the night before. Dad would, after the surgery, take out his dentures and tell me to put them in my purse, because they were trying to take them away. He was terrified, paranoid and impossible to settle down. All in all, I’d lost my dad, as he had been. And I never got him back.

 

We chalked up Dad’s behavior to the surgery. At first, we thought it was just swelling or something and it would get better. The paranoia did improve, once they got him off of some of the drugs, but Dad spent the next 10 years in a psychic hell. We, the family, have always felt it was because the scar tissue caused problems for the surgeon and, well, brain surgery is very precise. We tried to understand. Dad’s last ten years took a huge emotional toll on everyone in the family, but life is like that, sometimes.

 

After what I’ve been reading lately, I’m feeling that maybe, just maybe, some of Dad’s post surgery behavior was delirium from the trauma of the hospitalization, coupled with drugs. The surgery itself may have been part of it – likely it was. However, just read some of these quotes from Jane E. Allen’s article:

 

“...as more people survived their intensive-care stays, doctors began recognizing patterns in these terribly weakened patients. Many became uncharacteristically quiet and withdrawn. Others developed hyperactivity and confusion. Even after their bodies recovered enough to leave the ICU, some didn't bounce back mentally, or their physical recuperation lagged.

"Something about their hospital stays was changing patients' ability to speak, reason and relate to their loved ones. This combination of confusion and disorientation, often accompanied by paranoia and delusions, is called delirium.”