Book: End of Life Symptoms

6.3. Delirium - how can I help?

If you see a change in the person’s mental state or if you’re concerned about safety, then you should contact the GP, Public Health Nurse or specialist nurse.

Also consider the following:

·         Keep the environment calm and quiet, and if you can, limit the number of visitors. Try to keep the person in a normal sleep-wake pattern by using lights at the appropriate times, and reducing noise and stimulation at night.

·         If you think that delirium may be caused by withdrawal from nicotine, then nicotine replacement therapy, such as patches, may help to reduce symptoms.

·         Help the person to drink and eat regularly

·         Do not move the person unnecessarily

The Doctor may consider investigations and treatments, where appropriate, of underlying and reversible causes of delirium, such as infection, dehydration and electrolyte imbalance.

Doctors may try a low dose of a sedative or an antipsychotic. (Doctors won’t give an antipsychotic to a patient with Lewy body dementia, because of the risk of side effects.)

The role of medication in delirium at end of life is controversial. Drugs do not replace good nursing and supportive care.