When a hospital patient is admitted to the intensive care unit, it’s because their medical condition warrants closer attention than medical staff can give in other wards. When someone is in the ICU, highly trained personnel monitor and treat individuals, often using special equipment, until they no longer require critical care. Over the past years, there has been a growing awareness among healthcare workers about the potential consequences of a complication patients in the ICU may experience, known as ICU delirium. What are the symptoms of ICU delirium? Delirium appears quite suddenly and may come and go over a period of days. The patient’s state of mind is seriously affected and he or she cannot think clearly. People with ICU delirium may be incoherent or experience hallucinations. If you have a loved one in ICU, here are some signs of delirium you may see: Agitation or aggression Confusion Use of odd words or language Inability to pay attention Lack of awareness about their surroundings Unsure about the time of day or location Seeing things that are not there Abnormal movements, like tremors or picking at clothes Memory problems If you notice any of these symptoms, talk to the ICU staff about your concerns; they are trained to deal with delirium and can give medication if necessary. They may also enlist your help because interaction with familiar people can help reduce confusion and agitation in people who are delirious. Who gets ICU delirium? ICU delirium is very common. Estimates vary, but the occurrence may run as high as two out of three critically ill patients. There are multiple causes of ICU delirium and researchers are working to find out more about what lies behind it. What they do know is it can affect anyone, but older and sicker patients are more prone to develop it, as well as those who already have some cognitive impairment. People who are on a breathing machine may have a higher risk, which may be tied to less oxygen reaching the brain. Patients who have heart failure or who have undergone hip or heart surgery also have a higher rate of developing delirium. Infections, anesthesia, sleep deprivation, sedation and painkillers can also play a role, and the stress and unfamiliarity of the ICU can make some patients more likely to become disoriented and delirious. What are the risks of ICU delirium? Patients with delirium can have a slower recovery from their procedure or health condition and have significantly longer stays in the ICU and hospital. They are also much more likely to have one or more complications. There may be longer-term consequences as well. Patients who had ICU delirium are more likely to experience cognitive decline as long as three years after leaving the hospital, and there is evidence that higher rates of illness, PTSD and depression are all present in the years following ICU delirium. Of even more concern is the higher mortality rate among patients with delirium; they are three times more likely to die than patients who don’t develop it. How can ICU delirium be treated? Hospital workers can use an assessment tool called the Confusion Assessment Method for the intensive care unit if they suspect delirium, and they have other training and experience in recognizing the symptoms. If a patient is delirious, the staff will talk to the patient repeatedly about where they are and what’s happening to them. They will encourage patients to do things that will stimulate their thinking and if possible, get the patient to move around and do range of motion exercises. They also watch the patient for signs of dehydration, which can worsen delirium. If necessary, doctors can prescribe medication, including antipsychotics, to sedate patients who are hyperactive or distressed. If you know the patient well, the staff may ask you to help by taking some simple steps that may reorient the individual. Here are some techniques you can try: Speak quietly, using simple words or phrases. Bring favorite objects and photos when you visit. Remind the patient of the day and date. Talk about family and friends. ICU delirium is a common and serious event. Experts have mounted an ongoing campaign to educate medical professionals about the short- and long-term implications of ICU delirium, so they can address it effectively and quickly. Though it can be serious, it can often be reversed. As a friend or family member, you may have a role to play in helping your loved one get back on the road to recovery. Hearing a familiar voice and seeing a loved one’s face can help delirious patients regain their clarity and awareness, so be ready to pitch in if needed.