In the assessment of older-adult clients,it is often difficult to discriminate between delirium and dementia.Delirium is characterized by:

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Delirium is characterized by short,diurnal fluctuations in symptoms and is worse at night,in darkness,and on awakening.Delirium has an abrupt onset.Dementia has a slow progression.Delirium lasts hours to less than 1 month,seldom longer.Dementia may last months to years.Delirium is characterized by fluctuating alertness;the client may be lethargic or hypervigilant.Alertness is generally normal with dementia.

In the Assessment of Older-Adult Clients,it Is Often Difficult to Discriminate