Communication, reassurance and a calmer environment

NICE recommends clear communication, reorientation and reassurance for people with delirium. Involving family, friends and regular carers can help when appropriate. Delirium is often frightening and disorientating, and the person may be unable to explain what they are experiencing.

The NHS advises that, during acute confusion, staff should stay with the person, introduce themselves and explain where they are, use simple words and short sentences, and avoid asking many questions. Care staff can reduce distress and manage risk while waiting for clinical review.

Calmer communication habits

• Use one calm lead voice: multiple speakers can overwhelm the person.
• Keep sentences short: brief statements are easier to follow.
• Reorientate gently: say who you are, where the person is and what is happening now.
• Reduce stimulation: lower noise, lessen crowding, reduce glare and stop competing conversations where possible.
• Involve familiar people: family or trusted staff often help the person feel safer.
• Avoid arguing about their experience: focus on reassurance and safety rather than correcting perceptions.

Manager focus: antipsychotics are not first line

Calm communication supports treatment as well as comfort. Reassurance, clear orientation and reduced stimulation can lower avoidable distress.