“Grandma’s Not Herself—Could It Be Delirium?”

Sarah brought her 82-year-old grandmother home from the hospital last week. She had just been treated for a lung infection and seemed to be doing better. But three days later, something wasn’t right. 

Her usually cheerful grandmother started calling Sarah by the wrong name. She became restless at night, mumbling things that didn’t make sense. She said she saw people in the room who weren’t there. During the day, she seemed sleepy. 

Sarah was scared. Was this dementia? A stroke? Something else? 

What Is Delirium? 

Delirium is a sudden and serious change in how a person thinks, remembers, and understands the world around them. 

It can happen within hours or days, and symptoms often come and go throughout the day. Delirium is especially common in older adults, but it is not a normal part of aging. 

How Do You Recognize Delirium? 

Here are some common signs: 

• Confusion or disorientation (e.g., not knowing where they are or what day it is) • Trouble focusing or following a conversation 
• Talking in ways that don’t make sense 
• Seeing or hearing things that aren’t real (hallucinations) 
• Sudden mood changes—fear, anger, or anxiety 
• Being unusually sleepy or overly alert and agitated 

The symptoms appear suddenly and tend to fluctuate. A person may seem better in the morning and worse at night. 

Is It the Same as Dementia? 

Although people with dementia are more likely to develop delirium, the two are not the same. Here’s how they differ:

Why Is Delirium a Big Deal? 

Delirium isn’t just “confusion” due to old age. It could be the first sign of a serious medical condition. If untreated, it can lead to: 

• Longer hospital stays 
• A higher risk of falls and injuries 
• Worsening of existing health conditions 
• Long-term memory problems 
• Increased risk of death 

Who Is at Risk? 

Delirium is common in older adults, especially when they're unwell or in unfamiliar settings. Common triggers include: 

• Infections (e.g., urinary tract infections, lung infections) 
• Medication side effects (especially sedatives, painkillers) 
• Dehydration 
• Pain 
• Poor sleep 
• Constipation or urinary retention 
• Surgery or anaesthesia 
• Unfamiliar environments (like hospitals or care homes) 

How Can We Help Prevent and Treat Delirium? 

The key to treating delirium is identifying and treating the cause, such as: 

• Treating infections 
• Adjusting or stopping medications that may cause delirium 
• Managing pain or dehydration 

Other helpful strategies include: 

• Making sure the person has their glasses and hearing aids, if needed • Helping them stay oriented—gently remind them of the date, place, and who you are • Keeping the room well-lit during the day and quiet at night 
• Speaking clearly using simple words, and maintaining eye contact. • Encouraging hydration, nutrition, and gentle movement if safe 

The Takeaway 

If someone you love suddenly seems confused or just “not quite themselves,” don’t ignore it. It could be delirium, a serious but often treatable condition. Delirium can be unsettling, but with the right care, many people recover fully. What matters most is noticing the changes early and getting help. A little awareness can make a big difference.