Delirium

What is Delirium?

Delirium is a common medical condition characterised by the sudden/acute onset of confusion and a change in behaviour. It can develop in hours to days.

How common is Delirium?

It can affect up to a third of older patients in hospital, but can happen at any age. It is more common in those having surgery and on the Intensive Care Unit.

Who is at risk of developing Delirium?

People who:

  • Are aged 65 or older
  • Have memory impairment or dementia
  • Have previously experience delirium
  • Have conditions such as Parkinson’s disease or a previous stroke
  • Are very unwell
  • Have impaired eyesight and/or hearing
  • Have a broken hip
  • Have had an operation

What can cause Delirium to occur?

There may be multiple factors causing delirium including:

  • Severe illness
  • Infection – at any site
  • Pain
  • Dehydration, constipation and/or urinary retention
  • Derangement in electrolytes or sugar levels
  • Surgery
  • Starting or stopping certain medications
  • Excess alcohol intake or illegal drug use
  • Changes of environment

What do people with Delirium report?

“I saw and heard things that weren’t real”

“I had vivid dreams that were still there when I woke up”

“My mind seemed to have gone… I was in a different world”

“I don’t want them thinking I’ve gone potty”

What are the symptoms of Delirium?

People may present with:

  • New or worsening fluctuating confusion
  • Changes in behaviour
  • Restlessness or agitation, or being more quiet and withdrawn
  • Changes in sleeping pattern
  • Loss of control of bowel and bladder function

People with delirium are at a higher risk of complications including falls, developing dementia, deterioration of their dementia, longer length of stay in hospital and even death.

How can Delirium be treated?

Delirium is treated by a multidisciplinary team whom:

  • Treat the underlying cause/condition
  • Reduce things that can make it worse

Sedating medication is not usually recommended but may be considered if a person is:

  • Very agitated or distressed
  • Putting themselves or others at risk of harm
  • In need of sedation to conduct essential investigations or to give necessary treatments

How long can Delirium last?

Delirium usually lasts for a few days to weeks. Occasionally, it may continue for months.

What happens on leaving hospital?

Some people may still be more confused and less able than usual to carry out their daily tasks. Just by being at home can enable a quicker recovery.

We will try to ensure that people get the right level of support when they leave the hospital to help restore and maintain their everyday life.

What can you do to help your relative or friend with Delirium?

If you suspect or are worried about your relative / friend has delirium, please tell a staff member.

Delirium can be a very frightening and confusing time for those who are afflicted. Seeing a familiar face can be comforting and reassuring.

Visit as often as you are able. If you would like to visit outside of standard visiting hours, please speak to the nurse in charge of the ward.

These are some things you can do when you visit:

  • Stay calm and clearly and try not to overwhelm them
  • Remind them where they are, the date and time and what happened to bring them into hospital
  • Talking with them and keeping them stimulated. This can include doing puzzles or reading a book
  • Bring in familiar and favourite objects that they may find comforting
  • Assist and encourage with eating and drinking
  • Make sure they wear their glasses and / or hearing aids
  • Encourage them to walk if they are safe to do so. Nursing and therapy staff will be able to advise you if you are unsure.
  • If they are agitated or aggressive, try to establish a cause and call for help
  • Fill in the ‘This is me’ document to provide staff with information that will allow them to engage in a personalised way. Please ask a staff member for this.

How can Delirium be prevented?

Unfortunately, delirium is not always preventable. However, the following may help to prevent delirium or reduce its duration and severity:

  • Prompt treatment of infection
  • Limit changes in environment
  • Maintain normal sleep wake cycle
  • Maintain physical activity if possible
  • Ensuring adequate hydration and nutrition
  • Ensuring bowel and bladder function are maintained

If you have any concerns or questions:

Please talk to medical team or nursing staff on the ward or Dementia/Delirium Nurse Specialist.

Useful Websites:

Dementia support and advice is available:

Bedford Hospital – Call 07393267838 / 01234 355122 ext 3307

Monday to Friday 08:30 – 16:30

Luton & Dunstable University Hospital – Call 07816366320 / 01582 497417

Monday to Friday 08:30 – 16:30

Across both sites – 07904754123

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