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Delirium in older people

Episodes of delirium are most common among older patients

Information, guidance and tools to help you identify and manage episodes of delirium in older patients.

Delirium is a state of heightened mental confusion that commonly affects older people admitted to hospital. Ninety six percent of cases are experienced by older people. When older people with dementia experience severe illness or trauma such as a hip fracture they are more at risk of delirium.

Delirium causes great distress to patients, families and carers and has potentially serious consequences such as increased likelihood of admission to long term care and increased mortality.

People who have delirium may need to stay longer in hospital or in critical care; have an increased incidence of dementia and have more hospital-acquired complications such as falls and pressure ulcers.

Further delirium guidance and tools

Alzheimer's Society. Delirium

British Geriatrics Society. Delirium

NICE. Delirium: prevention, diagnosis and management. This guideline covers diagnosing and treating delirium in people aged 18 and over in hospital and in long-term residential care or a nursing home. It also covers identifying people at risk of developing delirium in these settings and preventing onset. It aims to improve diagnosis of delirium and reduce hospital stays and complications.

Royal College of Psychiatrists. Delirium. This information is for anyone who has experienced delirium, knows someone with delirium or is looking after people with delirium.

SIGN (2019) Risk reduction and management of delirium. This guideline provides recommendations based on current evidence for best practice in the detection, assessment, treatment and follow up of adults with delirium, as well as reducing the risk of delirium. 

Social Care Institute for Excellence and NICE (2017) Recognising and preventing delirium A quick guide for care home managers. This quick guide from NICE and SCIE will help care home managers and their staff to recognise the symptoms of delirium and to understand what they can do to prevent it.

RCN publications

Commitment to Care of People living with Dementia - SPACE principles

This guidance sets out the five principles that form a shared commitment to improving care for people living with dementia and their families. The document is designed to be used in a wide range of health and social care settings and has included the most recent evidence and best practice. 

In September 2017 the RCN older people's forum launched a project to raise awareness of delirium and encourage all members of the nursing profession, from a variety of settings, to sign up to become a delirium champion. The role of a delirium champion is to provide staff and colleagues with the tools to recognise early delirium, and to emphasise the need to escalate concerns about delirium in order to prevent harm.

The process to sign up to become a delirium champion has now closed whilst we evaluate the impact of the project and plan our next steps. However, to support delirium champions the older people's forum produced a short animated film and delirium resource pack which is now available for use by all in continuing to raise awareness of delirium.

We’d still love to hear from anyone using the delirium champion resources - so if you have any questions about use of the resource pack or how to feedback please contact the project co-coordinator


Delirium Champions  

4000 Audience reach of Delirium resources 
44% of

Delirium Champions are community based

My motivation to become a Delirium Champion was probably as a result of my late mother having the condition. It was masked by several other diagnostic possibilities so was largely overlooked.
The resources that were sent were useful and I did my sessions with both staff and patients on a one to one basis. I think it was a positive exercise and very useful for our service as we have a gentleman with dementia who suffers from delirium on a regular basis and it gave people a better insight into the condition.

I would recommend becoming a Delirium Champion as it is useful being able to provide training to the very people that benefit from it the most which is those who work on the 'floor'.

David Bishop Senior Staff Nurse, Danshell Group

Share your delirium case studies

If you've attended a delirium aware event, please tell us about the impact it's had on the care you provide.

For example, you escalated to someone else, assessed person further, transferred to hospital, started treatment.

By submitting this form, you are giving the RCN permission to share this information in print and online and to contact you about your case study. Please ensure you have anonymised information about any 3rd parties mentioned in this form.

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Page last updated - 27/06/2024