Share what has changed
Describe what is usual for your loved one and when you first noticed a change. Tell the team about hearing or vision needs and the routines that help them feel settled.
Understanding delirium
When thinking and awareness change.
A guide for survivors and families, drawing on the American Delirium Society and the Society of Critical Care Medicine.
What delirium can feel like
Delirium involves a sudden change in attention, awareness, and thinking during illness. Symptoms can fluctuate. A person may be restless, unusually sleepy, frightened, or unable to follow a conversation. Some people experience hallucinations or believe things that feel very real at the time. [1] [2]
Illness, medication effects, and sleep disruption can contribute, often together. The medical team looks for underlying causes and treats them. Delirium can occur in people with dementia as well as people without a previous memory disorder. [1] [6]
A sudden change needs prompt medical attention.
In hospital, tell the nurse or medical team right away about new confusion, unusual drowsiness, or a change from the person’s usual behavior. At home, seek urgent medical assessment for a sudden change in thinking or alertness. [2]
During illness & beyond discharge
Delirium and PICS
Delirium describes an acute change in brain function during illness. PICS describes new or worsened physical, cognitive, or mental health difficulties that continue after critical illness. Recovery may involve concerns about memory, concentration, distressing experiences, or day-to-day functioning. [6] [7]
Tell your follow-up clinician about ongoing symptoms and the experiences that worry you. You can ask what happened during the ICU stay, whether delirium was documented, and which recovery services may help.
Understand PICS →A familiar voice can help
How families can support care
Families can help the team understand the person’s usual thinking, communication, and routines. Work with staff to choose safe, reassuring ways to take part. [2] [3]
Offer calm reassurance
Use simple, gentle communication and familiar photos or objects when appropriate. Ask staff how you can help with comfort, orientation, and rest.
Ask for support, too
Ask about family updates, participation in rounds, and available emotional or spiritual support. Take breaks and tell the team when you need more help.
Sources: ADS patient and family guide [2]; SCCM family-centered care guideline [3].
Choose the guide that fits
American Delirium Society
For patients and families
Signs, causes, family involvement, and recovery information from ADS.
Read the guide (PDF) →American Delirium Society
For care partners at home
Understanding Delirium and Taking Action: a guide for adults and care partners in the community.
Read the community guide (PDF) →American Delirium Society
For families of children
Age-specific information in the ADS Pediatric Delirium Guide for Patients and Families.
Read the pediatric guide (PDF) →American Delirium Society
For palliative and end-of-life care
Information for patients and families navigating delirium in palliative and end-of-life care.
Read the palliative care guide (PDF) →Guides are hosted by the American Delirium Society. For videos and survivor accounts, browse ADS’s additional resources. Some accounts describe distressing ICU experiences.
Questions for your care team
Make room for the conversation.
- Could these changes be delirium, and what might be contributing?
- How are attention, alertness, and sleep being assessed?
- What can our family safely do to help?
- What should we watch for after discharge, and whom should we call?
SCCM’s ICU Liberation approach brings pain care, breathing and awakening assessments, medication choices, delirium care, mobility, and family involvement into a coordinated plan. Clinical decisions depend on each patient’s condition. [4] [5]
Sources & further reading
Reviewed . Summaries are for education; your healthcare team can explain how the information applies to your situation.
- American Delirium Society. What is Delirium? Patient education and introductory videos.
- American Delirium Society. Delirium Guide for Patients and Families (PDF).
- Hwang DY, Oczkowski SJW, Lewis K, et al. SCCM guidelines on family-centered care for adult ICUs: 2024. Critical Care Medicine. 2025;53(2):e465–e482.
- Society of Critical Care Medicine. ICU Liberation Bundle (A–F).
- Lewis K, Balas MC, Stollings JL, et al. Focused PADIS guideline update. Critical Care Medicine. 2025;53(3):e711–e727.
- Ottens TH, Hermes C, Page V, et al. The Delphi Delirium Management Algorithms. Delirium. Published January 12, 2024. doi:10.56392/001c.90652.
- Society of Critical Care Medicine. About ICU Liberation: goals, PICS, and recovery after critical illness.