What causes delirium?​

​​​​​​​​​​​​​​​​​​​There may be more than one possible cause of delirium. Some causes may be:

• medicine – certain types of medicines or combinations of medications (prescription and over the counter​)
• dehydration or not drinking enough fluids
• constipation or diarrhea
• infection, fever, pain, or an illness that’s getting worse
• a recent fall
• not eating well
• a recent surgery or procedure
• emotional stress
  
• problems with blood sugar (too high or too low) if you have diabetes
• a recent change in where you live or where you’re staying
• withdrawing from alcohol
• blood levels (for example, potassium, vitamin B12) that aren’t in the normal range

What puts you at risk for delirium?

There are many things that can put you at higher risk for delirium. Some include:

• increased age
• history of a brain injury or dementia
• if you had delirium before
• depression
• many health issues or you’re sick now
• ​​​​​​​​​​​​​​stressful events
• taking many types of medicine
• a recent change in any medicine you take
• problems with hearing or eyesight
• problems moving or getting around on your own
• frailty

​​​​​​​​​What's the difference between delirium and dementia?​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

Delirium comes on suddenly over a few hours, or a few days. For example, you’re more confused, agitated or even sleepier than usual. It may be temporary, but can last from a few days to several weeks. In some cases, it may take weeks or months to recover.

Dementia is a slow, steady decline in function over several months or years. Alzheimer’s disease is 1 type of dementia.

Delirium in someone with dementia can be hard to recognize. You may notice a sudden change in their behavior. You may also notice that they aren’t able to do things as well as they usually can or have trouble paying attention. An important first step is to tell your doctor, nurse, or other healthcare provider about the changes you see in yourself, a friend, or family member. Small changes caught early can make a difference.

If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse​ and ask about the Dementia Advice Line.

​​​​​​​​​​​​​​​​​​​​​How do you recognize delirium?

​​​In care settings staff members regularly look for signs of delirium. However, you or someone who knows you may be the first to notice you're different than usual.

​The questions below may help you recognize delirium in a friend or family member. If you check off more than 1 question, please tell your nurse, doctor, or other healthcare provider.

• Is there a sudden change in your ability to do things?
• Do you have more trouble paying attention to what's going on around you?
• Has your behaviour changed in the past few days?
• Does your speech ramble or do you jump from topic to topic? Are your words garbled and hard to understand?
• Do you have more trouble understanding what others say?
• Are you more forgetful than usual?
• Do you have more trouble recognizing people you know?
• Are you more confused about where you are or what time it is?
• Are you more worried, angry, troubled, or sad than usual?
• Does your mood change suddenly?
• Have you started to see or hear things that aren't there?
• Are you more restless or quiet than usual?
• Do you fall asleep during your visits from friends or family or are you harder to wake up?​​
  

If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse​ and ask about the Dementia Advice Line.​

​Can delirium be prevented or avoided?

​​​​​​​​For some people, delirium can be prevented. Here are some ways to try to prevent delirium:

• reviewing all the medicines you take with your healthcare provider – ask if any medicines can be stopped or if you can use a lower dose
• make sure you drink enough fluids and eat a healthy diet
• try to reduce stress (for example, treat pain, decrease noise and simplify routines)
• get support for your needs (for example, help with going to the bathroom regularly)
• make sure you get enough sleep at night

How can comfort rounds help?

Comfort rounds are a way staff, caregivers, or family in hospitals, care homes, or even your home can offer supportive care at regular times during the day and evening. It means staff, caregivers, or family intentionally check in often and provide the care you need at that time.

During rounds, they talk to you to let them know what's going on around you and check for any signs of delirium.

Staff will also:

• check to see if you're in pain
• help you to the bathroom
• offer a drink
• help you change positions when you’re in bed or take you for a walk if you're able

Staff will also make sure items such as water and the call bell are close by before they leave.

Your friends or family can help by talking to you about your memories, interests, and everyday events.

Ask if it's OK for you to go for a walk with your friend or family member, or if they can help you with moving in other ways. They can also help you with your meals to make sure you're eating well and drinking enough fluids. Before they leave, remind them to be sure to leave items like water and the call bell close by.​

If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse​ and ask about the Dementia Advice Line.​​

​​​​​​​​How is delirium treated?

There is no treatment for delirium itself. The​ goal is to treat the cause of delirium and keep you as comfortable as possible. Finding the cause usually means doing some tests and asking about any recent changes in your health. The cause of delirium may never be known.

Delirium can also happen in the last days and hours of life. The focus at the end of life is to keep you, your friend or family member comfortable.

​​​​​​​​How can I help my friend or family member with delirium?

• Speak clearly, softly, and use fewer words. Allow time to respond. They may need a minute to think about what they want to say.
• Don't argue with or correct them.
• Reassure them. They may be confused and frightened, so tell them you're there to help and to keep them safe.
• Make sure they're wearing their aids (like their glasses, hearing aids, or dentures).
• Keep the area around them calm and soothing.
• Use a clock to help them remember the time and a calendar or whiteboard to help them remember the date.
• Play their favourite music, as long as it's quiet and light.
• Leave the radio or TV off. The added voices and images may add to the confusion.

• Visit often but keep the visits short. In the early days of a delirium, someone may be asked to stay with their friend or family member as much as possible. Take turns so no one gets too tired.
• Visit at mealtimes so you can help make sure they eat and drink enough. Check with the nursing staff if you want to bring in food.
• Bring in items they know and may find comforting.
• Bring in a book for family and friends to sign whenever they visit. When they put their name in the book include the date and time they visited. This may help your friend or family member remember their visitors.

• Offer light and nourishing meals. Make sure they drink enough fluids to keep their urine pale.
• Help them move around or get some light exercise.
• Make sure someone is with them at all times.
• Remove anything that could be a safety risk.
  

​If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse​ and ask about the Dementia Advice Line.

​​​​​​​​​​​​​​​​​​​​​​​​​​Will your friend or family member ever be back to how they were before?

Delirium often clears in a few days or weeks. Some people may not respond to treatment for many weeks. Others may never go back to the way they were. The sooner the cause can be found and treated, the better the chance of recovery.

You may see memory or thinking problems that don't go away. Everyone is different. Please talk with your healthcare provider if you have questions or concerns.

If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse and ask about the Dementia Advice Line.​​​

• ​​​​​​​​​​​​​​​​​​​​​​Print Booklet - Delirium: Information for Patients and Families​
• Palliative care confusion
• Canadian Virtual Hospice - When Death is Near
• To learn more about programs and services for seniors with health issues, call Health Link at 811.

If you have questions about delirium or dementia call Health Link at 811. You can talk to a registered nurse​ ​and ask about the Dementia Advice Line.​