But what is delirium and how can you recognise it in the person you’re caring for?
Delirium is an acute confusional state or sudden confusion in a person which is caused by disturbances in the brain often triggered by illness or injury. Everyone’s delirium is different. Symptoms can fluctuate and often come on suddenly. People can change mood or alertness very quickly - they can become agitated or aggressive, or at the other extreme withdrawn or sleepy. They may experience hallucinations or unusual thoughts, feel disorientated, be reluctant to eat or drink and have difficulty following a conversation.
Who is at risk?
Anyone can get delirium if their illness is sufficiently severe.
But there are several factors that increase the risk, such as:
• Older age (over 65),
• Dementia,
• Having more than one illness,
• Having hearing or sight loss.
• A history of depression
• Alcohol misuse
What causes delirium?
Several factors can trigger delirium including:
• Infections
• Changes in medication
• A changed environment
• Surgery
• Dehydration or constipation
What can you do if you suspect delirium in someone you are caring for?
It is really important to identify delirium as soon as possible.
Relatives and carers are often the first to notice any changes in a loved one’s behaviour, and it's important to share this with medical staff or health professionals.
A quick and easy way to assess someone for delirium is by using the Delirium Diagnostic Tool, 4AT: https://www.the4at.com/trythe4at. This tool is designed for both healthcare professionals and caregivers, even those without formal training, making it simple to use if you suspect delirium. A score of 4 or more suggests delirium.
The role of unpaid carers and family members in recognising delirium
Dementia Action Teesside hosted a conference recently for World Delirium Day where Anna Wilson, Dementia Lead Nurse at South Tees Hospitals talked about the importance of carers and family members in detecting delirium.
Speaking to her after the event she said: “It is really important for staff to listen to relatives and carers who know the person best particularly in the content of an existing cognitive impairment to establish what the individual's normal cognitive function is like so delirium can be recognised and managed promptly. Do let staff know if you feel your loved one has changed from their baseline. The trust can offer a carers passport to facilitate flexible and open visiting.”
Dr Ahmad Khundakar, Senior Lecturer in Biomedical Science at Teesside University, also attended the event. He spoke very candidly about his own personal journey into delirium research which has been shaped by his mother’s experience of living with Parkinson’s disease and dementia, which highlighted how delirium can significantly affect both the person living with these conditions and their families.
He said: "Things could have been so different for my mother if her delirium had been identified and she had received the appropriate care."
Dr Khundakar is currently researching the impact of delirium on people living with dementia within care homes in South Tees.
The keynote speaker at the event, Dr Mani Krishnan, Consultant in Old Age Psychiatry; Associate Dean & Regional Lead NHS England, is a long-standing campaigner and advocate for delirium awareness. His efforts both locally in South Tees and internationally have helped raise awareness and effect change about delirium. His educational video (see below) has reached over 180,000 views on YouTube and provides an excellent explanation in simple terms.
Link to video
Please take 5 minutes to watch the video to have a better understanding of delirium.
Dr Krishnan is adamant that we all need to do more: “Having worked on raising awareness for over a decade I still feel there is a lot to be done. It was amazing to address colleagues at this event and look forward to collaborating more. Let’s make delirium everybody’s business!”
Neta Kaur-Brown, CEO Dementia Acton Teesside, added:
“Dementia Action Teesside was delighted to co-host our annual health conference in partnership with the Dementia Research Partnership Network at Teesside University. This year, we used our platform to raise vital awareness around Delirium, echoing the powerful words of Dr. Mani Krishnan: “Delirium is everyone’s business.”
Our joint efforts to spotlight the impact of Delirium—especially in the context of Dementia—are crucial not only for clinicians but also for the wider community, including caregivers and families. The conference welcomed a diverse group of up to 80 attendees, including clinicians, researchers, healthcare organisations, VCSE partners, carers, and members of the community, all of whom helped cascade this important information further.
As a local charity, Dementia Action Teesside remains at the forefront of raising awareness through our Dementia Friendly Communities initiative. We are committed to building a more empathetic and inclusive society for people living with Dementia and those who care for them, and this conference helped support our work.
What Can You Do?
Delirium is a serious condition that requires swift recognition and action. Caregivers play a critical role in identifying early symptoms. Use resources like the 4AT tool and seek medical advice immediately if you suspect delirium. Remember, simple steps like ensuring adequate hydration, maintaining a familiar environment, and promoting communication can make a significant difference in a person’s recovery.
Useful information
The following guide from Healthcare Improvement Scotland has been designed specifically for people who have experienced delirium and for their carers and contains useful information, including how to reduce the risk of delirium and how to treat it which is not typically through medication. It’s things like making sure the person has their hearing aids or glasses, reminding them to eat and drink, and speaking to them in a friendly and gentle way. Delirium Guide from Healthcare Improvement Scotland
