Harvard Health Letter

Preventing delirium in the hospital

Clocks and calendars may help patients stay oriented.

Being a hospital patient can be a disorienting and somewhat frightening experience. Being a hospital patient in the throes of delirium is a lot worse.

Delirium, which usually comes on suddenly, is a confused and scrambled state of mind. Memory and other types of thinking become disorganized. Hallucinations may occur. Symptoms fluctuate unpredictably, and the uneven course can make the experience even more bewildering. Classically, delirium has been associated with agitation and restlessness, but there's growing recognition that it can also put people into a hypoactive state that makes them withdrawn and seemingly drowsy.

Delirium itself can be very disturbing — both for the person affected and maybe even more so for loved ones observing the outward manifestations. But there may also be adverse consequences after the delirium has stopped. A meta-analysis published in 2010 found that delirium was associated with a higher risk of death, institutionalization, and dementia, even after controlling for factors like age and severity of illness.

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