Delirium

Learn how to recognize delirium, help prevent it, and know what to do when it happens.

What you need to know

Delirium is associated with increased health risks, including permanent brain disability or death
A quick response to delirium can prevent long-term complications
A healthy lifestyle is the best way to prevent delirium
A hospital experience can bring on delirium or make it worse, but there are ways to prevent this
Family and friends can play a big role in preventing and responding to delirium

Know your terms

Delirium isn’t an illness—it’s a collection of symptoms with many possible causes. If someone suddenly becomes confused, has trouble thinking, and starts behaving in unusual ways, that might be delirium.

Signs of delirium

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Delirium happens suddenly and can last several hours, days, weeks, or even longer. The symptoms come and go and are usually worse at night. A person experiencing delirium has a hard time making sense of what is happening around them. They might:

Have trouble paying attention (or only pay attention to one thing)
Not be able to follow a conversation
Say things that don’t make sense
See or hear things that other people do not see or hear
Seem nervous or scared or believe people are trying to hurt them
Be restless or angry
Be very quiet and withdrawn
Have trouble sleeping at night and staying awake during the day
Not know where they are

What you can do today: preventing delirium

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A healthy lifestyle is the best way to prevent delirium. Here are eight actions you can take:

1

Eat healthy food and drink enough fluids

Stay active

Do things that give your life meaning

This could include volunteering at your local community centre, religious institution, or political office.

4

Keep vaccinations up to date

5

Get your ears and eyes checked regularly

Wear glasses and hearing aids if you need them.

Stay connected to friends and family

Read more on our Social connection page .

7

See health care providers regularly

Go for regular check-ups and see a health care provider whenever needed.

8

Follow instructions for medications

Talk to your health care provider if you think your medications are causing problems.

Helping someone with delirium

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Get medical help right away

Delirium is caused by something, and that “something” needs to be discovered and treated without delay. Make sure the person with delirium gets medical help.

Sudden confusion or unusual behaviour should be medically evaluated right away.

Visit often

You can help them feel less anxious, provide support with their care, and talk to health care providers.

Talk to them

Speak quietly and in short, simple sentences.
Ask questions such as, “Do you feel you’re a little off today?” or “Are you feeling worried?”
Gently remind them of the day, time, and where they are.
Reassure them that they are safe and help is available.
If they are upset or can’t understand, move on and talk about other things.
If they are saying things that don’t make sense or are not accurate, don’t argue. Speak kindly and move the conversation to other things.

Make them comfortable

Keep background noise down.
Help them sit up or move around.
Sit them close to a window so the natural light can help regulate their sleep cycles.
Show them familiar objects, like pictures, food, or a favourite blanket.

Keep them healthy

Encourage them to eat and drink.
Take them outside for a walk if possible.
Encourage them to use glasses and hearing aids if they need them.
Encourage them to do things they enjoy.

Delirium is not dementia

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Delirium is a set of symptoms with many possible causes. Dementia is a set of symptoms caused by various brain diseases. They are two different things, but sometimes happen at the same time, which is confusing. Sometimes, delirium can look like dementia.

Delirium

Comes on suddenly
Symptoms come and go, or change often
Causes continual trouble paying attention
Is different from the person’s regular behaviour
Often occurs in people with dementia

Dementia

Begins very slowly
Symptoms do not go away completely
May cause trouble paying attention, but this might go away
Sometimes gets worse in evenings (called sundowning)
Is a big risk factor for delirium

A sudden change needs attention

Talk to a health care provider right away if any of the signs listed above suddenly appear, even if the signs come and go.

Causes

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Delirium has many causes, and often, more than one cause.

Events that can lead to delirium

Infection or other illness
Surgery (such as heart, hip, and eye)
Fall or injury
A stay in the hospital
A change in medication (stopping or starting a medication, or changing the dose)
A change in life situation (death of a loved one, a new living situation, a trip to the hospital)

Lifestyle habits that can lead to delirium

Not sleeping well
Not eating or drinking enough
Heavy alcohol and drug use
Not wearing hearing aids if needed, or having hearing aids that don’t fit right
Not wearing glasses if needed, or having glasses that don’t fit right

When to go to a hospital

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Sometimes, home is the best place for someone experiencing delirium, as long as they have seen a doctor and are following treatment. It is a familiar place where they feel comfortable. However, they should be taken to the hospital when they are:

Physically ill in a way that requires help right away, like a stroke or heart attack
Not safe—for instance, they are wandering out of the house or in danger of falling
Acting in an aggressive way that could be dangerous to themselves or others

Treatment

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There is no single treatment for delirium. Usually, the health care team will work with the patient and their family to learn about what caused the delirium. Then they will treat that cause. Sometimes, noticing the delirium can save a person’s life, because it helps the health care team find and treat a serious illness.

Delirium prevention in the hospital

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The hospital experience can cause delirium or make it worse. Statistics show that in hospitals:

40–50%

of older adults develop delirium after hip surgery

70%

of adults aged 65 and over who are in intensive care develop delirium

Why prevention matters

Untreated delirium can make recovery much harder. It might be the main reason someone needs to go into a care facility instead of going back home. It could be the reason someone ends up back in hospital soon after they leave.

Ask about delirium prevention

Some hospitals have a delirium prevention program. If you or someone you care for might be at risk, ask to be part of it.

Hospital staff play a big role in recognizing and treating delirium, but others can help.

Prevention tips for friends and family

Be there when you can

Go to the hospital with older adults and stay with them as much as possible.

Help with basic needs

If you are waiting with an older adult in an emergency room, make sure they eat, drink water, and stay as comfortable as possible.

Bring familiar and important things

Bring older adults who are in the hospital:

Things to remind them of home, such as photos, a blanket, or food
Their glasses, hearing aids with extra batteries, medications, and dentures

Tell the health care team what you notice

Talk to the health care team about any symptoms that worry you. You know what the person is like most of the time, so you can notice what’s different. You can help the health care team by telling them about the person’s usual behaviour, routine, and level of activity at home.