Distinguishing dementia, delirium, and depression in elderly patients

caring for elderly patients with dementia article & Carehome staff can detect the difference between delirium, dementia and depression

Caring for elderly patients with dementia

Dementia, delirium, and depression: The three Ds

Caring for elderly patients is a growing problem for nurses, and given the aging of the population the need for geriatric nursing is likely to increase. Nurses must be mindful of the three 'Ds' that can affect patients -- dementia, delirium, and depression. Dementia is the irreversible, slow cognitive decline due to Alzheimer's or other age-related complaints. Delirium is a temporary state of cognitive disassociation which occurs as a result of medications or other biological factors such as a lack of sleep. Depression is a mood disorder that can affect persons of all ages; however, the elderly are often particularly prone to depression due to life circumstances and the biological changes that occur as result of the aging process.

Slide 2: Caring for elderly patients with dementia

Patients with dementia require continued monitoring given the physical and psychological problems which may manifest themselves (Joosse, Palmer, & Lang 2013). Dementia is a chronic condition and regular data must be accumulated from caregivers to ensure that the specific needs of the patient's behavioral patterns are addressed (Joosse, Palmer, & Lang 2013: 110). For example, some patients with dementia may be particularly restless at night while others may feel anxiety and fear about not knowing where they are in space.

Slide 3: Detecting the differences between delirium, dementia, and depression

Another critical reason to obtain a full medical history from caregivers is the fact that other medical conditions that frequently affect the elderly can be mistaken for dementia. If the patient does not have a history of dementia, the caregiver should strongly suspect delirium or even depression may also be a factor.

Slide 5: How are they different

However, from the point-of-view of the clinician, the most important difference between all of these conditions is their cause. A patient experiencing delirium can potentially be returned to a coherent state if the underlying physical cause of the delirium can be addressed. A person with depression may not be irrational and unable to be reasoned with even though his or her mood is deflated and he or she may manifest a lack of affect: counseling and antidepressants are potentially beneficial treatments for a mood imbalance. In contrast, these forms of psychological counseling will not help someone with delirium and no pharmaceutical or therapy has been found to eradicate dementia.