This guideline covers diagnosing and treating delirium in people aged 18 and over in hospital and in long-term residential care or a nursing home. It also covers identifying people at risk of developing delirium in these settings and preventing onset. It aims to improve diagnosis of delirium and reduce hospital stays and complications.
In March 2019 we removed the use of olanzapine for the treatment of delirium in people who are distressed or considered a risk to themselves or others.
NICE has published separate advice for the care of people with alcohol-related physical health problems, including delirium related to alcohol use (known as delirium tremens).
This guideline includes recommendations on:
- risk factors of delirium
- indicators of delirium at presentation and daily observations
- preventing delirium
- diagnosing delirium
- treating delirium
Who is it for?
- NHS staff responsible for patients in hospital (including critical care) and long-term residential care settings (including primary care healthcare professionals)
- Adult hospital patients
- Adults in long-term residential care or a nursing home
- Family and carers of people with or at high risk of developing delirium
Is this guideline up to date?
We checked this guideline in October 2018. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline was previously called delirium: diagnosis, prevention and management.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.