An altered mental status is a difficult condition for nursing home residents to manage on their own, especially when symptoms can present slowly and brushed off for age-related memory loss, stress, medication side-effects, lack of sleep, or other conditions like dementia. Delirium, sometimes referred to as “sundowning” or “psychosis”, is one of those conditions that if misdiagnosed or treated with overmedication, can worsen quickly with irreversible outcomes including long-term cognitive impairments.
Delirium has been defined by The American Delirium Society (ADS) as a state of confusion that comes on very suddenly and lasts hours to days. If a nursing home resident becomes delirious, they may have hallucinations, disorganized thinking, difficulty understanding daily tasks, and inability to pay attention and be unaware of their environment or trust of the people in it. Delirium affects nearly 18% of long-term care residents and has a staggering 40% one-year mortality rate.
Nursing homes have been known to manage residents with disruptive behaviors in less productive ways, and many things can make delirium (and other mental conditions) worse, such as: