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March 11, 2026, marks World Delirium Awareness Day. To recognize the importance of delirium and what steps medical staff, patients, families and caregivers can take to prevent and treat it, here is a short Q&A with Raychel Moore, Nurse Practitioner (NP) in Geriatric Medicine Service and the NP Director of Senior’s Strategy at Michael Garron Hospital (MGH).
1. What is Delirium?
Delirium is a sudden new confusion; it can manifest as trouble thinking clearly, paying attention or understanding things.
2. What are the causes and triggers of delirium?
Delirium can be caused by an underlying illness such as infection, acute illness or dehydration. It can also be caused by medications, metabolic imbalances or a change in environment or routine such as being in a hospital. Risk factors for delirium are older age, existing memory problems, severe illness or hearing/vision loss.
3. Why does recognizing delirium early matter so much?
Untreated delirium increases the risk of permanent cognitive decline, longer hospital stays and higher mortality rates. Early identification is the starting point for recovery and protecting a patient's independence.
4. How long will it last and will a patient recover?
Delirium often improves in days or weeks as the underlying problem is treated, but it can also linger. "Brain fog" might last weeks or months, and some people may not fully return to their baseline, especially if they were frail or had dementia before.
5. Can delirium be prevented?
Delirium can be prevented first by trying non-pharmacological interventions. Simple actions such as encouraging movement and good nutrition as well as maintaining a normal sleep-wake cycle are highly effective.
6. What is the most important thing a family member or care partner can do?
Advocate for the patient. Use the Single Question in Delirium (SQiD) such as "Do you feel like your loved one has been more confused lately?". Family and/or caregivers will know the patient's baseline better than hospital staff, and your report of an acute change is the most powerful diagnostic tool available.
7. What are the hidden signs people should look for?
Look for hypoactive delirium, which is often missed. Hypoactive means that instead of being very restless , the patient may become unusually sleepy, withdrawn or quiet. Other signs include inattention, like being unable to keep track of a conversation or repeat the months of the year backwards.
8. How can delirium be prevented and managed?
There are many ways to prevent and manage delirium. This includes making hydration, pain assessment, toileting and mobility a priority. Having familiar objects and people during hospitalization can also help. Additionally, optimizing sensory support, such as ensuring patients have their glasses and hearing aids on can be helpful. Hospital staff can minimize environmental noise and unnecessary nighttime interruptions by clustering care in a timely manner.
9. How do I tell the difference between delirium and dementia?
The key is identifying an acute change from the patient's normal behavior, which often requires speaking with family members to establish their baseline. While both cause confusion, delirium is a sudden new change in someone's thinking within hours or days, whereas dementia is a chronic, progressive condition over months or years.
10. Can a patient have both at the same time?
Yes. Having dementia is a major risk factor for developing delirium, which is often called delirium superimposed on dementia.
11. Are medications or restraints the best option for agitation related to delirium?
While sedatives and physical restraints may seem easier or safer interventions in some environments, they can often worsen delirium and increase the risk for injuries thus should be avoided in favor of non-pharmacological strategies whenever possible.
12. Many people think hospital confusion is just a normal part of aging or being sick. Is that true?
No, that is not true. Delirium is an acute brain failure, while it is common; it is never normal and requires immediate medical investigation.
