The National Institute for Health and Clinical Excellence Clinical guideline CG103 on Delirium: diagnosis, prevention and management describes delirium as a ‘disturbance of consciousness or perception and confusion’. Delirium can have a sudden onset and symptoms can fluctuate. This can affect behaviour. The guidance also identifies that people with dementia are more at risk of developing delirium, and having delirium increases the risk of developing dementia. Some will have both conditions at the same time.
- Royal College of Psychiatrists (2010) Delirium leaflet. London, Royal College of Psychiatrists. http://www.rcpsych.ac.uk/mentalhealthinfo/problems/physicalillness/delirium.aspx
- National Institute for Health and Clinical Excellence (2010) Clinical guideline CG103. Delirium: diagnosis, prevention and management. London, NICE. http://www.nice.org.uk/nicemedia/live/13060/49909/49909.pdf
For some, in particular those people with a Lewy Body type dementia it is common to experience vivid hallucinations which are not the result of mis-perceiving the environment but are being created as a feature of internal changes to the brain.
A hallucination is an experience of any of the 5 senses that appears to the person experiencing it as real, but that reality is not shared by others. This can also lead to behaving in a different way to usual.
However it is important to ensure that the person actually is hallucinating and not just misperceiving information as this can lead to inappropriate use of medications.
A delusion is a belief that a person holds, despite evidence to the contrary, and is resistant to all reason. When people with dementia experience delusions, they may mis-understand what is going on in the present. They might believe that a carer is trying to poison their food or that a family member may be stealing money from their purse. Delusions can be frustrating and upsetting as they can affect how a person with dementia communicates with those around them.
Hallucinations and delusions are ‘very real’ to the person experiencing them.
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