Delirium in the Hospital

Delirium is a severe state of confusion. It often happens quickly and can come and go. It may involve changes in an individual’s thinking, attention, and perception. Most often this lasts for a short time.

Causes

Patients in the hospital are at high risk for developing delirium. It is especially true for patients in the ICU. Experts think delirium is due to changes in the way the brain is working. Causes may include:

• Severe illness

• Infections

• Not enough oxygen

• Alcohol withdrawal

• Certain medicines

• Lack of sleep

• Other treatments needed while in the hospital

Signs of Delirium

The staff is trained to know and treat delirium. Signs of delirium may change from day to day. Patients may be confused or not act as usual. They may see or hear things that are not there. Some people are unable to think or speak clearly or pay attention. Others have trouble staying awake or mix up days and nights.

Treatment

Treatment depends upon the cause of delirium. When patients become more stable, we try to keep patients comfortable yet alert. Avoid attached lines and drains each day or remove them as soon as possible. Get patients out of bed and moving. We also limit or remove medicines that may add to the patient’s delirium.

What You Can Do

While staff provides a safe setting, you can help support your loved one to feel safe. If your loved one has a normal routine, please share this with the nurse. See below for other ideas that can help.

Provide a Calm Environment

• Reduce noise by turning off the TV and radio in the evening.

• Reduce use of electronics (i.e., TV, cell phone, laptop, tablet, gaming devices) that may emit blue lights in the evening.

• Speak in a calm voice and use simple words to help your loved one know what is going on.

• Be sure your loved one has hearing aids, glasses, or any other devices needed.

• Bring in family photos or known items to give comfort.

• Use good lighting. Keep the lights on during the day and into the early evening. This helps to prevent confusion of voices and sounds.

• Promote good sleep practices. Encourage the patient to be out of bed during the day as much as possible. Limit daytime naps. Keep blinds open during the day and dim the lights at night.

Provide Comfort

• Sit with your loved one. Your company can be very helpful.

• Remind them of the day and date.

• Talk about familiar things such as family, friends, and hobbies.

• Bring electronic devices that allow your loved one to video chat and connect with those who are unable to visit.

• When your loved one is confused, it is ok to say “yes, you are confused.” Let them know it will likely go away.

After the Hospital

Talk about delirium and what happened in the hospital. This can help people sort out which memories are true and those that are not. Reassure patients of their fears. Let your primary doctor know that you or your loved one had delirium in the hospital.

When your loved one goes home, the delirium should improve. It may take time to adjust from the hospital routine. Use the listed strategies to keep their care and routine consistent.

Seeing your loved one with delirium can make you upset and leave you feeling helpless. Talk with the nurse or doctor about any concerns you may have or if you would like to know about other help. We are here to help you and your loved one.