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Delirium

What is delirium?

Delirium is a common condition among hospitalized patients, especially those in the ICU. Patients with delirium may have the following symptoms:

  • An inability to focus and maintain attention, which typically fluctuates over the course of the day;
  • Can't think clearly or remember recent events;
  • Disoriented, forgetful, and can't express themselves clearly;
  • Very sleepy or very agitated;
  • May see or hear things that do no exist (visual or auditory hallucinations);
  • May not recognize their family members or may be convinced that the hospital staff wants to harm them.

The ICU team is regularly looking for signs of delirium among ICU patients. However, family members are encouraged to notify the team if they observe that their loved one is not behaving as usual.

What causes delirium?

Unfortunately, we do not fully understand why some patients develop this state of confusion. But many ICU patients are particularly vulnerable. The following conditions may increase the risk of delirium:

  • Conditions affecting the brain such as a stroke, head trauma, Parkinson's disease and dementia;
  • Advanced age;
  • Hearing or visual impairment.

In addition, other complications or treatments required for the care of ICU patients may contribute to a state of confusion, including:

Can anything be done to help prevent delirium?

Both the ICU team and family members can help with the prevention of delirium by making the ICU environment feel a little more normal. These measures include:

  • Limiting noise and light at night to favor sleep;
  • Getting patients out of bed when possible;
  • Re-orienting patients so they are aware of the time of day, where they are and who are the people around them;
  • Limiting the use of catheters and physical restraints;
  • Providing enough, but not too much stimulation;
  • Treating pain appropriately;
  • Providing hearing aids and eyeglasses to the patients who need them.

What can be done to treat delirium?

  • There are no magical pills or tricks to treat delirium;
  • The calming measures used to help prevent delirium are also used to bring it to the end;
  • Certain medications may be used to control the agitation of some patients when they are at risk of injuring themselves or others.

When will the delirium be over?

  • Delirium can last hours, days, weeks or even months;
  • It is often the last thing to improve once the other medical conditions have resolved;
  • Even when the symptoms of delirium appear to have resolved, patients and family members may continue to notice changes in memory or ability to complete certain daily tasks.

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Location and contact

Critical Care Medicine

Sunnybrook Health Sciences Centre
2075 Bayview Avenue, 
D-wing, 1st floor
room D1 08
Toronto, ON M4N 3M5

Phone: 416-480-4522
Fax: 416-480-4999

For information about patients admitted to Sunnybrook's Intensive Care Units, please contact the unit through the hospital switchboard at 416-480-6100