Delirium

September 2023 - This web page and the resources contained within are currently under review.

Delirium is a common serious condition for older people. It is identified as an acute deterioration in mental status arising over hours or days. Illness, surgery and medications can all cause delirium. It often starts suddenly, but usually lifts when the condition causing it gets better. It can be frightening – not only for the person who is unwell – but also for those around him or her.

Delirium is a serious medical emergency and statistics suggest that the prevalence of delirium in people on medical wards in hospital is about 20–30%, while 10–50% of people having surgery develop delirium. People who develop delirium may need to stay longer in hospital or in critical care, have more hospital-acquired complications, such as falls and pressure ulcers, be more likely to need to be admitted to long term care if they are in hospital, and are more likely to die. Delirium is a recognised problem in older people that is frequently overlooked or misdiagnosed and is very distressing to individuals and to their families and carers.

Who is at risk of delirium?

Any patient can develop delirium, but certain factors can increase the risk. These include:

• older people – the risk increases with age.
• older people taking multiple medicines.
• people with dementia.
• people who are dehydrated.
• people with an infection.
• severely ill people.
• people who have had surgery, especially hip surgery.
• people who are nearing the end of their life.
• people with sight or hearing difficulties.
• people who have a temperature.
• older people with constipation or urinary retention.

A previous collaboration with the Scottish Delirium Association, NHS Education for Scotland and colleagues across NHSScotland, Healthcare Improvement Scotland developed a range of tools and resources to support improvements in the identification and immediate management of delirium. This toolkit had been produced to provide easy access to all of these tools and resources.