For Family and Caregivers

What Is Delirium?

Delirium is typically caused by some other medical illness (such as pneumonia) or after surgery, working together with one or more of the following:

  • Being older (70 and above), though younger people are also at risk
  • Taking some medications
  • Being dehydrated
  • Being malnourished
  • Being bedbound or immobile
  • Loss of senses (such as hearing or visual problems)
  • Lacking stimulation (such as no interaction with other people, no familiar objects around to see, no calendar or clock to orient to time)

Symptoms of Delirium

The face of delirium can be very different between people and for the same person at different times. Any combination of cognitive and behavioral changes can present themselves.

  • Reduced awareness of the person’s surroundings and problems with attention (such as asking the same questions over, or giving the same answer over and over even though you are asking a different question, or the person may not be able to talk with you at all)
  • Not knowing the day, month, year, or where they are
  • Not remembering why they are in the hospital, that you came to visit the previous day, or information you told them a few minutes ago
  • Conversations that make no sense or speech that you cannot understand
  • Not able to sleep at night and sleepiness during the daytime. A common belief is that the patient needs his/her rest during the day because they do not sleep well at night. This belief is not correct
  • Picking at clothing, trying to get out of bed without assistance, pulling out IVs, taking off clothes, yelling, trying to hit people
  • Sleeping too much, not answering questions, not moving much, not eating
  • Illusions (such as thinking a coat on a chair is a person)
  • Hallucinations (such as seeing imaginary people, animals or insects)

How Healthcare Providers Treat Delirium

  • Quickly identify and treat the underlying medical and/or surgical problem(s) contributing to the delirium
  • Lower the dosage of or stop those medications which can be associated with the delirium
  • Ensure proper hydration
  • Ensure proper nutrition
  • Help the delirious person become active as quickly as possible, according to an assessment of their abilities (such as get them out of bed and in a chair or walking with the assistance of physical therapy)
  • Remove tubing (such as urinary catheters) as soon as possible
  • Remind them of the date, time, place, who their hospital caregivers are, why they are in the hospital, what medications they are receiving and why. Update the orientation board in their room daily
  • Provide medication only when necessary to treat dangerous behaviors (such as pulling out IV lines, hitting staff and family) and to treat hallucinations

How YOU Can Help With the Delirium Treatment

  • Make sure you, other family, friends, and caregivers visit the delirious patient as often as possible
  • Bring things to the hospital to help with orientation (such as clock, calendar)
  • Talk to the delirious patient, work on puzzle books, read, play games