Elderly people who experience hallucinations of deceased friends or family members could be showing signs of dementia with acute delirium, a psychiatrist said, urging relatives to help them seek prompt medical evaluations.
A woman in her 60s, surnamed Lin (林), exhibited signs of acute memory loss when she repeatedly asked the same question, which her family dismissed as old age, Jianan Psychiatric Center General Psychiatry Department director Shen Cheng-che (沈正哲) said.
The woman later began to report seeing deceased relatives and having auditory hallucinations, Shen said.
Photo: Su Fu-nan, Taipei Times
Lin also repeatedly told her family that “someone is outside for her” and often tried to go out during the night. After becoming concerned for her wellbeing, her family took her to the center for medical examinations, Shen said.
The geriatric psychiatry healthcare team at the center examined Lin’s conditions and conducted assessments, he said.
Lin was diagnosed with mild dementia with acute delirium, he said.
The team identified the physical factors that induced the condition and prescribed medical treatments for the woman, Shen said.
Lin’s condition has since stabilized, with her symptoms significantly improving, he said, adding that dementia-related medicines were administered to delay any cognitive decline.
Early-stage dementia is not readily apparent, as signs such as mild forgetfulness, slowed responses or decreased concentration are usually confused by family as signs of normal aging, Shen said.
Therefore, the best timing for early intervention is usually missed when more serious cognitive issues or psychiatric symptoms develop, he said.
People with dementia are prone to acute delirium particularly when physical illnesses occur, such as infection, dehydration, electrolyte imbalance, medication effects or other acute conditions, Shen said.
Delirium is characterized by its rapid and sudden attacks, in which the person might experience confusion, hallucinations or drastic emotional changes within only a few hours or days, as well as displaying behaviors that are different from their personality, he said.
Shen also said that there are six major signs of dementia including decreased concentration, slowed responses, emotional instability with tendencies toward restlessness, fear or agitation, hallucinations or delusions, reversed sleep schedules with easy agitation in the night, and sudden, significant behavioral changes.
Prompt medical evaluation is required, especially when such signs are recognized in elderly people with pre-existing memory issues, he said.
Delirium cannot be treated by simply suppressing symptoms with medication, but by identifying underlying physical causes and choosing appropriate therapies accordingly, he said.
Once their condition has stabilized, patients then need a long-term treatment plan, which might include medical therapy, lifestyle adjustments and caregiver counseling, Shen added.
People are advised to take their elderly relatives to see a doctor if they display behavioral changes that are significantly different from before, such as hallucinations, impaired judgment, emotional instability or disrupted sleep schedules, the center said.
Identifying dementia and delirium through professional medical evaluation would not only reduce discomfort for patients, but would also relieve the stress for their family, allowing elderly people to receive appropriate medical care, it said.
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