Strategies to Manage Delirium

What do I do if I suspect that the person in my care is in a delirium? Here are some suggestions.

• Stay Calm

Try to stay calm. Here are some strategies that might help.

• A person in a delirium can say strange things; they may answer questions incorrectly. This is not their fault. Try to remain patient and not argue with them if they are not making sense. Staying calm lessens feelings of anxiety and/or frustration for both you and the person experiencing a delirium.
• Saying things like, “I believe you” or “it’s going to be okay” may help calm their nerves. Let them know that you are with them and that they are safe, even if they are hallucinating. For example, rather than saying, “there are no snakes, you are hallucinating”, you could try saying something like, “I know you see snakes on the floor and that you are scared, but I am here with you and you are safe”.
• Talk to the person about delirium. It is okay to talk about it rather than pretend nothing is wrong. By letting them know you understand what is going on and you have a plan, you may decrease fear and anxiety. For example, “I can tell you are not feeling well. It’s okay. You are safe and we are going to figure this out together.”
• Give very simple directions.  Long explanations may be difficult to understand when experiencing a delirium. For example, you could give directions like, “eat this” or “drink this” or “follow me” in a calm voice.

• Quiet

Create a Quiet and Familiar Environment:

• If possible, have a familiar person stay with them so they are not alone.
• Limit noise, such as radio or television. You can try soothing music but turn it off if it causes agitation.
• Dim the lighting in the room. Shadows from bright lights can increase hallucinations.
• Ensure that the person is wearing their glasses, dentures and hearing aids. It is important that they can communicate what they need and hear what you are saying.

• Status Quo

Encourage the Usual Routine:

• Encourage them to be as active as they normally would, safely indoors.
• Encourage them to eat and drink at mealtimes by offering simple meals and easy to eat foods. It is important to encourage good nutrition even if the person is not hungry or thirsty.

• Get Help

Seek Medical Attention as Soon as Possible:

• Any suspected sudden change in mental status should be reported to a health care professional as soon as possible. The cause for the change needs to be determined. 
• An assessment and diagnosis of delirium, as quickly as possible, will lead to a proper plan of treatment and action.
• Ideally, you would connect with a trusted health care professional who is aware of the person’s health history as soon as possible. However, if this is not possible, seek medical attention from your closest medical facility (e.g. walk-in-clinic, emergency department, etc.)

Try to stay calm. Here are some strategies that might help.

• A person in a delirium can say strange things; they may answer questions incorrectly. This is not their fault. Try to remain patient and not argue with them if they are not making sense. Staying calm lessens feelings of anxiety and/or frustration for both you and the person experiencing a delirium.
• Saying things like, “I believe you” or “it’s going to be okay” may help calm their nerves. Let them know that you are with them and that they are safe, even if they are hallucinating. For example, rather than saying, “there are no snakes, you are hallucinating”, you could try saying something like, “I know you see snakes on the floor and that you are scared, but I am here with you and you are safe”.
• Talk to the person about delirium. It is okay to talk about it rather than pretend nothing is wrong. By letting them know you understand what is going on and you have a plan, you may decrease fear and anxiety. For example, “I can tell you are not feeling well. It’s okay. You are safe and we are going to figure this out together.”
• Give very simple directions.  Long explanations may be difficult to understand when experiencing a delirium. For example, you could give directions like, “eat this” or “drink this” or “follow me” in a calm voice.

Activity 6.4

Try a Tool

There are trusted strategies that you can use that may prevent delirium from developing. For proven ways to prevent delirium, see Strategies to Prevent Delirium