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Delirium

Information for patients and relatives

An elderly man looking at his partner with a concerned expression on his face with his arms around her comforting her.

What is delirium?

Delirium is caused by a disturbance of brain function. It is used to describe a state of sudden confusion and changes in a person’s behaviour and alertness.

How common is delirium?

It is very common and frequently occurs in patients in hospital with other problems. It is most common in older people and those with pre-existing memory problems such as dementia. It is also more common in patients who are on a breathing machine, in intensive care for example.

What increases risk of developing a delirium?

Certain conditions and chemical changes in the brain can lead to an increased risk of developing a delirium. There is often more than one cause of delirium, and certain people may develop a delirium because of a less severe cause such as constipation.

Some conditions that can lead to a delirium include:

  • dementia

  • surgery – especially heart or hip surgery

  • an illness of the brain, such as a stroke or head injury

  • a terminal illness

  • depression

  • heart failure

  • an infection or sepsis

  • medications such as painkillers or sedatives

  • pain

  • malnutrition

  • constipation

  • poor eyesight and / or hearing

What are the symptoms of delirium?

A person with a delirium can show symptoms including:

  • confusion;
  • distractibility;
  • rambling speech;
  • changes in alertness;
  • agitation (sometimes leading to aggression);
  • behavioural changes;
  • changes in personality, including paranoia;
  • hallucinations.
The symptoms are often worse at night, meaning that a person is awake at night and sleepy during the day.

What it is like to have delirium?

You may:

  • be less aware of what is going on around you;
  • be unsure of where you are or what you are doing there;
  • be unable to follow a conversation or to speak clearly;
  • hear noises or voices when there is nothing or no one to cause you harm;
  • have vivid dreams or hallucinations which are often frightening and may carry on when you are awake;
  • see people or things which aren’t there;
  • worry that other people are trying to harm you;
  • be very agitated or restless, unable to sit still;
  • be very slow or sleepy;
  • sleep during the day but wake up at night;
  • have moods that can change quickly, for example; frightened, anxious, depressed or irritable;
  • be more confused at some times than others, often in the evening or at night;
  • feel upset towards your family for not taking you home.

Helping someone with a delirium and coping
as a carer

It can be very distressing to witness a relative or friend who is showing symptoms of a delirium.

It is important to remember that the person with a delirium is often unaware of the reality of who you are, where they are or why they are there.

This can cause them to become distressed and frightened and can make it difficult to engage and provide support to them. By regularly reminding them where they are and reassuring them that they are safe, you can help to calm their anxieties and fears.

Try to stay calm and speak slowly and softly, about familiar non-threatening topics to
re-direct their thoughts towards things that help them become more content. This can include using music, items from home such as photographs, to engage with them.

The symptoms are normally short lived, but can last several weeks or sometimes months. The duration of the change depends on the severity and resolution of the underlying cause.

The ward staff may be able to keep you informed about the likely cause of delirium and will try to facilitate you staying with the person while they are having treatment, if they feel that it will be beneficial.
An image of a carer holding a patients hand. Offering help and support.

  • Delirium is common

  • Delirium is treatable

  • Relatives can stay to help us

Useful information

Dementia UK helpline / website

Anyone with a question or concern about Dementia (including Alzheimer’s disease)
can call our Dementia Helpline for free on 0800 888 66 78, send an email to [email protected] or visit the dementia website for further information.

Carers Together

Carers Together offer local, friendly and confidential services that aim to ease the pressure of caring. Our team of staff and volunteers are on hand to help carers with any issues they may face, including benefits, health problems, housing, training, employment, taking a break from caring or concerns about the person they care for.

Telephone: 01642 488977
Email: [email protected]
Visit the carers together website

Contacts

If you would like to speak to a member of staff or ask any questions about delirium please telephone the manager or sisters on Ward 34 on 01642 854534 or you can speak to them directly if you are currently in the hospital.

Further sources of information

Animated video from the Dementia Together NI team to raise awareness of Delirium, its signs and symptoms. You can view the GoAnimate delirium animation on YouTube

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850
Adapted with permission from the Public Health Agency (PHA)
ST0540