- Reference Number: HEY1591/2025
- Departments: Corporate, Elderly Medicine, Palliative Care Team, Trustwide - Adult
- Last Updated: 30 November 2025
What is Delirium?
Delirium is a sudden change in mental state which may include confusion, agitation, personality change, difficulties with understanding, and memory loss. Delirium can be distressing to the person and those around them, especially when they don’t know what’s causing these changes.
Delirium may be the first sign that someone is becoming unwell and, if identified early, can be treated. If delirium is suspected, tests will be carried out to look for possible causes and, through treating the underlying cause(s), the delirium itself can be treated. The recovery time is different for each person; some with underlying dementia may take longer to get better. For more information on dementia, turn to page 6.
What are the symptoms of delirium?
Family, friends and carers are often best placed to recognise and describe signs of delirium because they know the person best. A person with delirium may be unaware of the changes and will often be unable to describe them. Below is a list of changes to look out for.
- Being easily distracted
- Become quieter or more sleepy than usual
- Having less awareness of where they are or what time it is (disorientation)
- Suddenly not be able to do something they could previously (for example, walking or eating)
- Being unable to speak clearly or follow a conversation
- Experience sudden changes in mood
- Experience hallucinations (seeing or hearing things which are often frightening, that are not there)
- Experience delusions or become paranoid (strongly believing things that are not true, for example that others are trying to physically harm them).
Symptoms of delirium often come and go over the course of a day or may vary from day to day.
Who gets delirium and why?
Anyone can develop delirium, but people who are older, frailer, having visual or hearing loss and those with dementia are at the highest risk. Having a serious illness or being in hospital with a broken hip can also increase this risk.
Delirium is extremely common for patients requiring intensive care and can be particularly distressing (ask a member of the care team for further information on psychological difficulties in ICU).
Delirium can be triggered by many things. Some of the common causes are:
- pain
- infection
- surgery
- constipation
- urinary retention
- dehydration
- alcohol or drug withdrawal
- environmental changes
How can I help someone with delirium?
Alert medical or nursing staff if you think someone has delirium. Medical staff will assess the patient fully and address all the triggers for delirium. In addition, a supportive and calm environment can also help someone recover from delirium, particularly if the person with delirium is agitated or distressed. Nursing staff, and visiting family and friends, can all help by:
- talking calmly to the person in short clear sentences, reassuring them as to where they are and who you are
- supporting the person with familiar objects from home, such as photographs
- making sure that any hearing aids and glasses are clean and working and that the person is wearing them
- setting up a 24-hour clock and calendar that the person can see clearly
- helping the person develop a good sleep routine, including reducing noise and dimming lights at night
- reassuring the person if they have delusions
- supporting the person to be active – to sit up or to get out of bed – as soon as they safely can
- make sure they have their walking aids so they can move around safely
- helping the person to eat and drink regularly, you may need to wake the person up if they are sleeping through the day
- provide the right amount of stimulation. Stimulating the person too much can make things worse. Reduce noise as much as possible
- not moving the person unnecessarily – either within and between hospital wards, or into hospital if delirium is being managed at home.
Non-medical approaches are more likely to be effective at helping the person with delirium to feel safe and relaxed, and hospital staff should encourage relatives to support the patient with these approaches where possible.
After delirium
The symptoms of delirium get better in most people over a few days to weeks, once the underlying cause is treated. However, a person with delirium may have to stay in hospital longer.
Although some people recover fully, delirium can also have lasting consequences after it has been treated. This is more common in older people.
- A person may have distressing memories of delirium, sometimes linked to feelings of fear or anxiety, for months afterwards. Those close to the person should support them to talk openly about their experience and feelings. If they’ve kept a diary of the person’s time with delirium, they can use this to help the person make sense of their experience once they’re getting better.
- Delirium is linked to a faster worsening of a person’s mental abilities and function, meaning someone’s level of independence can be affected.
What is dementia?
How do we support people with dementia?
- Work in partnership with the person living with dementia, and their families/carers, in care planning and decision making with flexibility to suit the patient and family.
- Train our Training is provided for all staff to enable them to provide person centred care with respect for the person as an individual and recognising their life story.
- Assess for early identification of dementia. The use of assessment and screening by skilled staff to ensure any symptoms of dementia or delirium are identified and care adapted to the patient.
- Provide environments which are dementia friendly. We try to minimise the number of moves around the hospital, encourage the personalising of bed spaces, and offer rehabilitation activities that support independence and stimulation.
What do we provide?
At all our hospitals we provide an opt-in scheme to promote dementia awareness and assist us in providing person centred care. This includes gathering information of the patient’s life story and involving family and carers in care planning to support the patient in their daily activities such as eating and drinking, continence and comfort. Please speak to a member of staff for further details.
John’s Campaign recognises the importance of family and carers during a patient’s stay in hospital. We encourage flexibility around visiting hours to support your loved one living with dementia.
Volunteers are working with therapy teams within our hospitals to provide stimulation and activities. We have pet therapy dogs who have been a valued addition to the volunteer team and visit the wards regularly. Families can arrange a visit from the therapy dogs via email.
For Hull University Teaching Hospitals (HUTH): hyp-tr.huth.volunteers@nhs.net
For Northern Lincolnshire and Goole NHS Foundation Trust (NLAG): nlg-tr.twvolunteering@nhs.net
Dementia champions on every ward and care environment in the hospital to promote dementia awareness.
We have a Dementia Lead Consultant and Dementia Specialist Practitioner for HUTH. And Dementia Clinical Nurse Specialists based at NLAG. They are available for further advice and support (please see a member of staff for details).
NLAG offer Hospital Carers lanyards to help identify carers and include them in patient support. We view carers as expert partners, respecting and listening to their views.
Care and Decision Making
Sometimes people with dementia/delirium may not be able to make their own decisions because of cognitive decline. When a patient cannot make their own decisions about hospital health care, health care staff will liaise with relatives/carers to make decisions in the best interest of the patient. Relatives/Carers know the person best and are able to represent the views of the person to inform decisions and choices. Staff will be following the Mental Capacity Act process and relatives and carers are central to this process when a person cannot make their decisions. If a person has legally appointed one or more people to help them make decisions or to make decisions on their behalf, known as A Lasting Power of Attorney (LPA), we must see the original LPA document and take a photocopy to be placed in the front of the patients’ inpatient notes. We cannot treat an LPA as being valid until we have seen it.
Additional services
Mental Health Liaison Service
Sometimes we will refer a patient to the older person’s mental health team for further advice, support and to also begin the process in reaching a diagnosis of dementia or delirium. We also refer for guidance on the use of medication to manage symptoms associated with dementia or delirium.
Memory Services
We will sometimes make a referral to the memory clinic in the community following discharge. The team work with the person and their relative/carer to ensure a quality assessment and treatment process that takes everyone’s needs into account.
Further Information
Delirium
National Institute for Health and Care Excellence (NICE) – Delirium: prevention, diagnosis and management in hospital and long-term care
https://www.nice.org.uk/guidance/cg103
Royal College of Psychiatrists Delirium Information – https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/delirium#:~:text=Delirium%20is%20a%20state%20of,an%20’acute%20confusional%20state‘
Dementia
Alzheimer’s Society – Information, advice and support to people with dementia and their family/carers
Tel: 01472 359247 or https://www.alzheimers.org.uk/
Age UK – Information, advice, support, activities and services on tel: 01482 324644 or https://www.ageuk.org.uk/
Herbert Protocol – National scheme used by Humberside police to assist in locating a person living with dementia that goes missing or does not return home when expected. www.humberside.police.uk/issues/vulnerability
Mental Capacity Act – https://www.legislation.gov.uk/ukpga/2005/9/contents
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You. www.hey.nhs.uk/privacy/data-protection
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
This leaflet was developed by Dr J. Garfield, Clinical Psychologist with the Department of Psychological Services, in collaboration with Consultant Geriatrician and Dementia Lead Dr Y. Nagandran, Dementia Specialist Practitioner M. Ashurst and Dementia Clinical Nurse Specialist K. Scott, and will be reviewed in November 2028.
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
This leaflet has been produced by the Hull University Teaching Hospitals NHS Trust and is available as a download:
Download the “Delirium and Dementia Care in Hospital” leaflet
