The elderly are currently the biggest utilisers of the healthcare system and the proportion of elderly inpatients will continue to rise as Singapore faces the silver tsunami. The prevalence of cognitive issues among our elderly inpatients is about 40-50%. Currently, half of the elderly living with dementia in Singapore have not received a formal diagnosis. Establishing a diagnosis of dementia helps the healthcare workers understand the nature of the cognitive and behavioural symptoms. Without a diagnosis of dementia, the caregivers miss out on opportunities for dementia education and are often left helpless when their loved ones become confused and disorientated.
While the elderly patients are under our care in the wards, those with cognitive issues are at higher risk for fall, delirium, incontinence and exhibiting challenging behaviours which may result in physical restraint usage. Differentiating delirium and dementia among the elderly inpatients who are confused is important since delirium is an acute problem and is also a medical emergency which can potentially be life threatening. Delirium is reversible once the medical insults are dealt with. In this lecture, we explore the differences between dementia and delirium and discuss the management strategies for delirium.
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