Delirium in Critical Care

Information for family, friends and carers

This leaflet aims to help you understand delirium.  It describes the causes, the main symptoms and how we manage them, as well as how you can help. 

We hope the leaflet will help to answer some of the questions you may have. If you have any further questions or concerns, please speak to the doctors or nurses caring for your relative or friend.

What is delirium?

Delirium is a period of short-term confusion. It effects up to 7 in 10 (70%) of patients in Critical Care at some time during their stay. 

The patient's state of mind changes very quickly and their personality can change, making them behave out of character. This change in behaviour and personality is temporary. It usually lasts for only a short time.

There are two types of delirium:

Patients can have both types of delirium. Sometimes they are withdrawn and at other times they are agitated. They can quickly switch from one state to the other.

What are the symptoms?

Common symptoms include:

Patients with either type of delirium can hallucinate. Hallucinations are when you see or hear things that are not there. They can also have bad dreams, which may feel real to them. These dreams can make them paranoid. Patients with delirium can even believe that staff or family members are trying to hurt them.

How long does it last?

Delirium is usually temporary and lasts for a few hours or days. In some cases, it can last for several weeks or even months, and symptoms can change depending on the time of day.

It does get better. Most patients recover completely, and do not remember how confused they were.

Does delirium have long-lasting effects?

Although most patients fully recover, some have continued problems with concentration and memory. Some patients have flashbacks and nightmares about their stay in hospital.

It is good for patients with these problems to talk about their experiences of Critical Care.  We run follow-up clinics, where we help them to manage these issues.

Is delirium the same as dementia?

No. Delirium is a temporary mental state from which most patients recover. Dementia is a syndrome associated with an ongoing decline in brain function. There are many different causes of dementia and many different types.

Who is at risk of delirium?

All patients admitted to Critical Care are at risk of delirium but some are more likely to develop it than others. They include people who:

What causes delirium?

There is no one single cause of delirium. Patients often develop it for many reasons including:

How do you care for patients in Critical Care who have delirium?

Critical Care staff assess and monitor our patients every day, to spot those who have the early signs of delirium. Diagnosing delirium early can help make it less severe.

Please tell us if you think the patient you are visiting has signs of delirium, so we can assess them and help with their symptoms.

Things we do to help

How can family, friends, and carers help?

It can be distressing to see a relative or friend with delirium. It is important for you to understand that they are not aware of reality. There are many things you can do to help to ease their delirium.

What happens when patients leave Critical Care?

When patients leave Critical Care they usually go to another ward before they are able to go home. We will pass their medical information on to the new ward, and let staff know if they have had or still have delirium.

Critical Care Follow-up and Rehabilitation Team

The Critical Care Follow-up and Rehabilitation Team will contact you once you are discharged home. A telephone assessment will establish whether you need further help. This could be to help you gain physical strength via physiotherapy, or psychological help.

Further information

The charity ‘ICU Steps’ offers support for ex-Critical Care patients and relatives. Their booklet Intensive Care: a guide for patients and relatives is available on their website.

Who should I speak to if I have any questions or concerns?

If you have any questions or concerns about your relative or friend, please speak to a member of Critical Care staff.

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

If you would like to give us feedback about this leaflet, please fill in our short online survey. Either scan the QR code below, or use the web link. We do not record your personal information, unless you provide contact details and would like to talk to us some more.

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