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Delirium: the care you should expect

Delirium is a change in a person’s mental state or consciousness that develops over hours or days. It may appear as confusion, difficulties with understanding and memory, or personality changes. Older people and people with dementia, severe illness or a hip fracture are more at risk of delirium. It can affect up to 1 in 3 hospital patients in the UK, but is potentially preventable in about a third of these people. We want this guideline to make a difference to adults in hospital or long-term care by making sure:

  • healthcare staff ‘think delirium’ whenever people are admitted to hospital or long‑term care to improve early recognition of delirium
  • delirium is prevented, if possible, in people identified to be at risk
  • health or social care practitioners assess for delirium if a person’s behaviour changes (for example, if they become confused and agitated or withdrawn and quiet)
  • healthcare professionals diagnose delirium quickly and accurately
  • delirium is treated first if it is hard to tell if a person has dementia or delirium
  • delirium is treated urgently so that hospital stays are shorter, and related problems (such as falls and pressure sores) and risks of dementia and death are reduced.

Making decisions together

Decisions about treatment and care are best when they are made together. Your care team should give you and your family or carers clear information, talk with you about your options and listen carefully to your views and concerns.

They should also:

  • make sure you always have a say in your care, or that decisions are made in your best interests if you are no longer able to make your own decisions
  • involve family members or carers if you are happy with this
  • work closely with other care teams and share information so that everyone knows your needs.

If you need more support to understand the information you are given, tell your care team.

Read more about making decisions about your care.

Where can I find out more?

The NHS website has more information about delirium.

The organisations below can give you more advice and support.

NICE is not responsible for the content of these websites.

To share an experience of care you have received, contact your local Healthwatch.

We wrote this guideline with people who have been affected by delirium and staff who treat and support them. All the decisions are based on the best research available.

ISBN: 978-1-4731-4954-0


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