Delirium is a very common problem among critically ill patients, particularly among older adults or those with risk factors such as brain injury or chronic alcohol use. Critical illness, discomfort and medications are a few of the many possible factors that contribute to the development of delirium. Delirium can lengthen the duration of both the ICU and the hospital length of stay, make it more difficult for the patient to breathe without a ventilator, and places the patient at risk for self-removal of life-saving tubes and equipment.

While some delirious patients may be agitated or paranoid, others can appear “flat” and non-responsive. Delirium may present with agitation, paranoia, or a very flat and distant affect. Patients may hallucinate and interpret real situations in bizarre ways (e.g. it is common for patients to think that staff members are trying to harm them). Family members may be the first to notice subtle changes in the patient’s behavior.

CCTC is part of a national critical care initiative aimed at prevention, recognition, and early treatment of delirium. Family members may be able to help prevent or minimize delirium through the following strategies:

  • Provide accurate accounts of a patients home medications or alcohol use
  • Supply corrective eyewear and/or hearing aids as soon as a patient is awake; dentures when the patient is no longer intubated orally
  • Bring familiar items such as a favourite pillow or blanket , face soap and shampoo.
  • Personalize the patient’s room with family photos.
  • Provide headsets with the patient’s favourite music or relaxation tapes
  • If a DVD player is available, family movies can help keep a patient connected to those unable to visit
  • Orient patients to the date and time of day with each visit, and posting calendars or clocks within the patients line of vision
  • Speak to the patient in a calm and reassuring manner during visits, and remind him/her of the location and reason for hospitalization
  • Avoid overwhelming a patient with large numbers of visitors, or loud/excitable visits
  • Promote day and night routine; lights on during daytime (except afternoon nap) and quiet, dark nighttime environment with minimal interruptions
  • Some delirious patients will become more relaxed with a calm and quiet family member at the bedside; speak to the nurse at the bedside regarding the most effective approach for your family member.

Last Reviewed: October 23, 2014

LHSCPatients, Families & Visitors

Last Updated October 23, 2014 | © 2007, LHSC, London Ontario Canada