Delirium
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Delirium

Delirium is a sudden change in thinking and behaviour. It becomes more common near the end of life and is often distressing for the person and those around them. Delirium can develop quickly or gradually and varies in severity and duration. It may have multiple causes, some which can be managed or reversed. These include:

  • Medications such as opioids and sedatives
  • Infections such as urinary tract infections or pneumonia
  • Dehydration, pain, or constipation
  • Organ failure.

Recognising the signs, reassuring, and addressing any reversible causes can help reduce distress and improve care.

What I can do

Learn to recognise the signs of delirium. Be aware that some people will become agitated or restless while others will be withdrawn and quiet. Common signs include:

  • Sudden memory loss or confusion with difficulty concentrating or communicating
  • Changes in sleep patterns
  • Hallucinations, delusions, or suspicious, impulsive or inappropriate behaviour.

Provide comfort and support by:

  • Keeping the person in a quiet, familiar space with gentle lighting
  • Speaking calmly and clearly, repeating information as needed (e.g. ‘It’s Tuesday, you’re in your room, and I’m here to help.’)
  • Involving family or familiar staff members—this can reduce distress and help with recognition of changes.

Assess for any unmet needs. Is the person in pain, dehydrated, or constipated? Is the environment too hot, cold, or noisy?

What I can learn

Nurses can learn more on recognising, assessing, and managing delirium in the CareSearch Nurses Hub.

Explore the current research evidence on this topic by reading the Delirium CareSearch Clinical Evidence Summary.

Enrol in the free 8-week Decoding delirium online course by Dementia Training Australia.

Prescribers can find advice on managing agitation at the end of life in the CareSearchgp and palliMEDs apps.

What I can give

When delirium is confusing or distressing for families and carers, these resources may help:

What I can suggest

Provide regular staff training on recognising, assessing, and managing symptoms of delirium.

Support families and carers by offering them education on delirium, its progression, and how to support a person while they are experiencing it.

Familiarise staff with the eight quality statements of the Delirium Clinical Care Standard (2021) by the Australian Commission on Safety and Quality in Health Care.


Page created 25 February 2025