On this page you’ll find information on Delirium risk factors and symptoms

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Delirium is defined as an acute confusional state lasting from hours to weeks, characterised by changes in sleep-wake cycle, attention, perception, thinking, memory and psychomotor behaviour.

  • Over 75
  • Acute/chronic illnesses
  • Trauma (surgery, fall, fracture)
  • Previous delirium episode
  • Medication side effects, toxicity
  • Sensory losses (sight, hearing)
  • Social losses, isolation
  • Abnormal body temperature
  • Diagnosis of dementia/cognitive impairment/depression
  • Infection (URTI, UTI)
  • Dehydration
  • Pain
  • Environment
  • Nutritional deficiencies
  • Alcohol

Sudden changes in:

  • Sleep/wake cycle
  • Ability to do ADL’s
  • Communication (incoherent speech, rambling thoughts)
  • Attention and concentration
  • Perceptual changes (hallucinations, illusions)
  • Thought processes (delusions)
  • Memory
  • Psychomotor activity
  • Confusion assessment method
  • Assessment for causes

Treat underlying physiological cause:

  • Investigations (e.g. renal function BT, CRP, MSU)
  • 1500mls of fluid daily (unless restricted)
  • Medication review
  • Antibiotics if raised CRP/infection
  • Stabilise disease
  • Treat constipation/urinary retention
  • Pain management
  • Pharmacological interventions

Sleep hygiene:

  • Keep a regular bedtime
  • Release tryptophan with warm milk, yoghurt, salmon/turkey sandwiches on wholegrain bread
  • Eliminate caffeine
  • Reduce light/noise stimuli
  • Bedtime voiding
  • Sleep stimulants: Aroma, music
  • Stabilise body/room temperature

Tools:

  • CAM
  • 4AT
  • 6CIT
  • Sleep/wake chart
  • Behaviour monitoring chart
  • Clock drawing
  • Patient/carer leaflet

Environmental:

  • Hearing aids, glasses and dentures
  • Calm, soothing atmosphere

Supportive:

  • Consistent carers
  • Speak in clear, short, simple phrases

Pharmacological:

  • Hypnotics
  • Antipsychotic for delusions and agitation
Page last updated: 8 August 2024