Jordan Ellis
Hospital delirium is a temporary but serious condition that affects cognition, causing sudden confusion, disorientation, and changes in consciousness, perception, attention, and mood. It is common in older adults, especially those with dementia, and can be induced by hospital stays, particularly in intensive care units. While it can be challenging to prevent delirium, caregivers can play a crucial role in supporting patients by providing familiar sensory stimuli, maintaining regular schedules, promoting healthy habits, and offering reassurance and empathy.
| Characteristics | Values |
|---|---|
| Condition | Hospital delirium is a temporary but serious condition that affects a person's mental state, causing sudden confusion, disorientation, and changes in consciousness, perceptions, attention, and mood. |
| Risk Factors | Older age, pre-existing cognitive impairments, dementia, hospitalization (especially in ICUs), mechanical ventilation, certain medications, sleep disturbances, and unfamiliar surroundings. |
| Symptoms | Inattention, lethargy, confusion, hallucinations, mood changes, emotional upset, behavioural changes, memory problems, and reduced responsiveness or alertness. |
| Treatment | Address the underlying cause, regulate sleep-wake cycles, provide sensory stimulation (e.g., familiar music, photographs), ensure proper nutrition and hydration, encourage physical activity, maintain a calm and quiet environment, and provide reassurance and support. |
| Prevention | Avoid risk factors, provide a familiar presence, initiate conversations, orient the person, encourage proper nutrition and hydration, ensure adequate sleep, and involve healthcare providers in planning care. |
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What You'll Learn
- Provide sensory stimuli such as familiar music, photographs, or tactile objects
- Maintain a schedule to regulate sleep-wake cycles
- Encourage healthy habits like proper nutrition and hydration and adequate sleep
- Offer reassurance that they are safe and receiving care
- Consult healthcare providers to share observations and learn how to help
Provide sensory stimuli such as familiar music, photographs, or tactile objects
Delirium is a serious condition that affects cognition, causing sudden changes in thinking, awareness, and mental state. It can lead to confusion, emotional upset, behavioural changes, memory problems, hallucinations, and mood changes. Hospital delirium is especially common in older adults, with one-third of patients aged 70 or older experiencing it. It can be caused by medications, illness, injury, surgery, or the hospital environment itself.
Familiar music
Playing music that the patient enjoys or finds calming can be soothing and help reduce stress. It can also stimulate their senses and provide a sense of familiarity and comfort.
Photographs of family and friends
Showing the patient photographs of their loved ones can help orient them to time and place. It can remind them of their personal connections and support systems, providing a sense of security and comfort.
Familiar objects from home
Bringing familiar items from the patient's home, such as a favourite blanket, book, or tactile objects with interesting textures, can provide comfort and help stimulate their senses. These objects can create a sense of familiarity and serve as reminders of their personal space and identity.
Conversation and reading
Engaging in conversation with the patient, using a calm and patient demeanour, can provide sensory stimulation through verbal interaction. Reading books or letters to the patient can also provide sensory input and help maintain cognitive engagement.
It is important to be patient and understanding when communicating with someone experiencing delirium. Keep conversations basic and focused on one topic at a time.
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Maintain a schedule to regulate sleep-wake cycles
Hospital delirium is a serious condition that affects cognition, causing sudden changes in consciousness, perceptions, attention, and mood. It can cause confusion, disorientation, and challenges with memory, speech, and other everyday activities. It is important to maintain a regular day and night schedule for someone with delirium to help regulate their sleep-wake cycles. Here are some ways to do this:
Firstly, ensure the person is getting enough sleep. Create a calm and quiet environment for them to sleep in. Turn off the TV, reduce noise, close the curtains, and keep the lights dim at night. On the other hand, during the day, open the curtains to let in natural light. This will help the person with delirium differentiate between day and night and regulate their sleep-wake cycle.
Encourage the person to get out of bed and sit in a chair during the day. Help them work with a physical therapist or occupational therapist to maintain a healthy routine. Make sure they are eating well and staying hydrated, as proper nutrition and hydration are essential for maintaining a healthy sleep-wake cycle.
Additionally, maintain a calm and comfortable environment for the person with delirium. Reduce noise and limit interruptions during the night. Be patient and compassionate, as delirium can cause frustration and agitation. Reassure the person that they are safe and receiving care.
It is also important to help orient the person with delirium to time and place. Use a calendar and clock to remind them of the date and time of day. Talk about current events and things inside and outside their room. Familiar items from home, such as a favourite blanket or book, can also help provide a sense of comfort and familiarity, aiding in maintaining a regular schedule.
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Encourage healthy habits like proper nutrition and hydration and adequate sleep
Hospital delirium is a serious condition that affects cognition, causing sudden changes in consciousness, perceptions, attention, and mood. It can lead to confusion, disorientation, and challenges with memory, speech, or other daily activities. It is important to encourage healthy habits like proper nutrition and hydration and adequate sleep to support recovery. Here are some ways to do that:
Nutrition and Hydration
- Help your loved one eat and drink. Hospital delirium can cause a person to forget or become confused about medical instructions, so ensure they are consuming enough food and liquids.
- Offer them their favourite foods or drinks, if possible. This may help to improve their mood and encourage them to eat and drink more.
- If they are having difficulty eating or drinking, consult their doctor or nurse for advice. They may recommend nutritional supplements or feeding assistance.
- Familiar items from home, such as a favourite mug or bowl, can provide comfort and encourage proper nutrition and hydration.
Adequate Sleep
- Establish a calm and quiet environment to promote better sleep. Reduce noise, close the curtains, and turn off the lights or keep them dim.
- Limit interruptions during the night by reducing the number of tests or procedures that are scheduled after hours, if possible.
- Encourage a regular day and night schedule to help regulate their sleep-wake cycle. During the day, open the curtains to let in natural light and help them stay awake.
- If they are experiencing fear or agitation, sleep or calming medications may be prescribed by their doctor to aid in rest and recovery.
By encouraging healthy habits like proper nutrition and hydration and adequate sleep, you can support your loved one's recovery from hospital delirium and reduce their risk of developing further complications. Remember to always consult their healthcare team for guidance and support tailored to your loved one's specific needs.
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Offer reassurance that they are safe and receiving care
Delirium is a serious condition that can be distressing for the person experiencing it and those around them. It can cause sudden changes in a person's mental state, including confusion, disorientation, and changes in consciousness, perception, attention, and mood. Hospital delirium is especially common in older adults, with one-third of patients aged 70 or older experiencing it. It can be caused or exacerbated by the hospital environment, such as unfamiliar surroundings, sleep disturbances, and certain medications.
To offer reassurance that they are safe and receiving care, it is important to remain calm and patient. Here are some specific actions you can take:
- Orient them to time and place: Help the person understand where they are and why they are in the hospital. You can use a calendar and clock to remind them of the date and time of day. If they are in a shared room, show them the other patient behind the curtain, with their permission.
- Provide a calm and quiet environment: Reduce noise and lights, especially at night, to help them sleep. During the day, open the curtains to let in natural light.
- Maintain a familiar presence: As a familiar presence, you are already helping to reduce their risk of hospital delirium. You can further reassure them by bringing familiar items from home, such as their favourite blanket or book.
- Encourage healthy habits: Ensure they are eating well, staying hydrated, and getting enough rest.
- Support their sensory needs: Provide sensory stimuli such as their favourite music, photographs, or tactile objects to help maintain their cognitive engagement.
- Communicate with healthcare providers: Keep an open line of communication with the medical team and share any observations of behavioural or cognitive changes.
Remember, delirium can be frightening for the person experiencing it, so it is important to remain calm, patient, and empathetic while providing reassurance and support.
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Consult healthcare providers to share observations and learn how to help
Delirium is a serious condition that can be extremely distressing for the person experiencing it and those around them. It is a sudden change in a person's mental state, causing confusion, disorientation, and changes in consciousness, perceptions, attention, and mood. It can also cause challenges with memory, speech, or other everyday activities. It is important to consult healthcare providers and share observations to help the person experiencing delirium. Here are some ways to do that:
Communicate with the medical team
Keep an open line of communication with the medical team and promptly share any observations of changes in behaviour or cognition. It is important to be patient and compassionate as individuals experiencing delirium may become frustrated or agitated. Maintain a calm and empathetic demeanour while providing reassurance and support.
Educate loved ones
If someone is at high risk of delirium, educate their loved ones about the signs and how they can offer support. Delirium can be frightening for both the person experiencing it and those around them. Educating loved ones can help them understand the condition and provide better support.
Monitor risk factors
Work with healthcare providers to identify and monitor risk factors for delirium. This includes older age, pre-existing cognitive impairments, such as dementia, and environmental factors such as unfamiliar surroundings and sleep disturbances. By identifying risk factors, healthcare providers can put measures in place to help prevent delirium or minimise its impact.
Understand the underlying causes
Delirium is often caused by an underlying illness or injury. Work with healthcare providers to understand the underlying causes and contributing factors. This will help them determine the best treatment approach. Treatment for delirium typically involves addressing the underlying cause, which may include infections, reactions to medications, or other health conditions.
Plan for ongoing care
If the person with delirium is discharged from the hospital, their clinical team can provide advice and arrange for additional care and support if needed. This may include health and social care professionals who can provide ongoing assistance during their recovery.
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Frequently asked questions
Hospital delirium is a temporary but serious condition that affects a person's mental state, causing sudden confusion, emotional upsets, and behavioural changes. It is often caused by an illness or injury.
Symptoms include inattention, lethargy, confusion, problems with awareness, hallucinations, and mood changes. Delirium can also cause challenges with memory, speech, or other everyday activities such as walking, reading, or eating.
It is important to be patient and understanding. Help orient the person by telling them where they are and why they are in the hospital. Remind them that they are safe and that their care team is there to take care of them. Encourage proper nutrition and hydration, and make sure they are getting enough sleep. Provide sensory stimuli such as familiar music, photographs, or tactile objects.
Treatment for hospital delirium involves addressing the underlying cause, which can vary from person to person. In some cases, medications may be prescribed to help manage symptoms, such as sleep or calming medications. However, it is important to note that some sedating drugs can make delirium worse.
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