Family and Caregivers
What Can Families Do?
It is important for you, as a family member, to help health care professionals recognize the signs and symptoms of delirium.
Because you are familiar with how your loved one normally appears, you are able to recognize when their thinking or behavior changes abruptly.
It is important that you discuss these concerns with the health care professionals. By doing so, you provide valuable information about your loved one’s normal condition and abilities that allows the doctor to recognize that the problem may be delirium.
What can you do for a family member with delirium?
Be calm and reassuring.
Speak slowly and clearly and use simple sentences about familiar, non-threatening topics.
Don’t argue with them or try to test their memory or thinking.
Don’t over stimulate them.
Allow periods of uninterrupted rest to reduce fatigue.
Encourage adequate fluid and nutritional intake.
Let hospital staff know if you notice any discomfort.
Increase activity when applicable (e.g., encourage them to be up and walking when it is safe to do so).
Keep track of changes in behaviour and inform the doctor or nurses.
Ensure hearing aids and glasses are in place.
Make sure they can get to the bathroom regularly.
Place a calendar and clock within view.
Talk about changes in your loved one.
Even if no one asks.
A Delirium Scenario
This scenario is presented for educational purposes only. It is not intended as medical advice. If you believe your loved one is experiencing delirium, contact a health professional immediately.
Margaret is an 83 year old woman who lives with her husband, Bert. They are managing pretty well. Bert has a bad heart, so he gets out of breath easily, but he does what he can to help around the house. Margaret had a stroke a few years back, and her memory hasn’t been quite the same since. Bert takes care of paying the bills, lays out the pills for the both of them, keeps an eye to make sure the burners are turned off, and they do the shopping together. They take walks around the apartment complex together, for exercise.
One Saturday, Margaret says she feels tired and wants to take a nap after lunch. This is unusual for her, as she is not a napper, and they usually take one of their walks on Saturdays after lunch. She wakes up with a start 30 minutes later; she struggles to get off the couch and rushes to the bathroom. She loses some urine on the way, and it soaks down the leg of her pants. She goes into the bedroom to change her pants. Bert finds she still smells of urine, and finds out that she only changed her pants, not her underwear. Margaret seems confused and upset, and calls Bert “Richard” by mistake, which is their son’s name. She says “Richard, what are we having for lunch”, when in fact she and Bert have already had lunch. Bert reminds her they’ve already eaten, and she gets angry and argues with him. Bert is frightened by this new onset of confusion.
This is delirium.
Although Margaret has had a less-than-perfect memory since her stroke, this is a big, sudden change. This is not the same Margaret as yesterday. The first thing that Bert needs to do is recognize that this change in her means that Margaret might be having a new medical problem that is causing the confusion. The problem is called delirium. He should bring her to the doctor’s office. If the doctor’s office is closed, then he should bring her to a walk-in clinic or the emergency room.
It turns out that Margaret has a bladder infection. She is sent home from the emergency room with a prescription for an antibiotic. The doctor in the emergency department tells Bert that she may still have some confusion for a few days or even weeks, even after the antibiotic has started working on her bladder infection. Delirium can take a little while to clear up, even when the right treatment for its cause (in Margaret’s case the infection) is started.