Following up an adult with delirium

At minimum, review a patient with delirium daily. If delirium does not resolve within a week, review the suspected cause(s) and treatment. Consider alternative diagnoses, and whether further investigation is required. Consider whether the patient could have dementia, especially dementia with Lewy bodies, and whether the symptoms of delirium and dementia are overlapping. Optimising nonpharmacological interventions (see Principles of managing delirium in adults) may improve symptoms of delirium.

Delirium is not always transient; almost half of patients with delirium in hospital do not completely recover before discharge. Close liaison between the hospital and other care providers (eg general practitioner, residential care staff) at the time of discharge is essential, as is ongoing vigilance about drugs that can impair cognition, environmental changes and sensory problems—see Preventing delirium and Principles of managing delirium.

Patients who have experienced delirium are often troubled by frightening memories or misconceptions about their time in hospital. Explain the nature of delirium and reassure them to reduce distress.

The Australian Commission on Safety and Quality in Healthcare (ACSQHC) Delirium Clinical Care Standard - Consumer fact sheet is a useful source of information.