How can families help an elderly person experiencing delirium?

Families can play a vital role in helping an elderly person experiencing delirium by providing a supportive environment, monitoring symptoms, and communicating effectively with the medical team. Delirium is a mental state characterized by confusion and an inability to think clearly, which often starts suddenly and is treatable [1].

Understanding Delirium and Its Causes

Delirium is not a disease in itself, but a syndrome resulting from an underlying medical problem. Common causes can include infections (such as urinary tract infections or pneumonia), dehydration, electrolyte imbalances, medication side effects or withdrawal, or post-surgical states [1]. It is crucial to identify and treat the underlying cause, as addressing the cause often leads to complete recovery [1]. Symptoms may include changes in alertness, confusion, disorganized thinking, and sleep disturbances [1].

Creating a Supportive Environment

Providing a calm and familiar environment can significantly help manage delirium symptoms. Ensure the room is well-lit and quiet. Having a clock or calendar within reach, and surrounding the person with familiar personal belongings, can help reorient them [2]. Furthermore, having family members present and keeping the same caregivers as much as possible can reduce confusion and anxiety [2]. If the person uses glasses or hearing aids, ensure they are wearing them to enhance communication [1].

Effective Communication and Monitoring

Family members should communicate clearly and simply with the person experiencing delirium. Speak slowly and clearly about familiar, non-threatening topics, and use a calm and reassuring tone of voice [4]. Remind them frequently of where they are, the time, and the date [4]. If they experience hallucinations, explain that they are not real and offer reassurance. If they insist the hallucinations are real, do not argue, as this may make the situation worse [4]. It is essential to monitor for any changes in symptoms and report them to the medical team. These changes may include levels of alertness, sleep patterns, or new behaviors such as agitation or withdrawal [1]. Delirium can be dangerous, especially if it affects the ability to make decisions, increasing the risk of falls or dehydration [2].

When Should You Contact the Medical Team?

Families should contact the medical team immediately if they notice the sudden onset or worsening of delirium symptoms [3]. It is essential to work with doctors to identify the cause of the delirium and develop a treatment plan [2]. Questions to ask the doctor might include: Is my family member at risk for delirium? What is the cause of the delirium? And what problems should we contact you about? [2]. In some cases, medications may be needed to control symptoms such as aggression or agitation, but these medications require careful monitoring by a doctor due to potential side effects [2]. You can learn more about delirium in general by visiting the Delirium: Sudden Confusion and Mental Changes in the Elderly page (Arabic).

Medical references

• Delirium
• Delirium: Cancer Treatment Side Effect
• Sudden confusion (delirium) - NHS
• Information for carers about delirium | CUH