Preventing delirium in everyday care

NICE recommends a tailored multicomponent package for people at risk of delirium. Many of the recommended actions are routine care done reliably: consistent staff, clear orientation, adequate fluids, safe mobility, pain review, working glasses and hearing aids, and better sleep conditions.

Prevention is especially important after admission, return from hospital, an acute illness, a fall, infection or a change in medicines. These events can destabilise someone’s usual mental state.

Everyday prevention actions that matter

• Use familiar staff where possible: NICE notes that familiarity helps and unnecessary room moves should be avoided.
• Support orientation: ensure good lighting, clear signage, visible clocks and calendars, and give simple regular explanations.
• Encourage fluid intake and address constipation: low intake can quickly increase delirium risk.
• Look for and treat pain: this is important when the person cannot communicate verbally.
• Keep people moving safely: walking aids should be accessible and used as needed.
• Check sensory aids: glasses and hearing aids must be available, working and used.
• Promote sleep: reduce noise at night and avoid unnecessary checks that disturb sleep.

Delirium prevention is often built from basics: familiarity, orientation, fluids, mobility, pain control, sensory support and sleep.