This systematic review, published in August, looked for randomised and quasi-experimental trials of non-drug interventions aimed at recovery from established delirium in adults. It found only 11 studies.
Interventions varied widely in content, dose and duration. Most were delivered during the acute admission, only one continued after discharge, and few addressed emotional recovery, such as distress, fear or memories of the delirium. Long-term follow-up was limited.
The review could not show which interventions work, because the evidence is too thin and varied.
For clinicians, the gap is the message. Many older people leave hospital still recovering from delirium, with families who do not know what to expect. Until better evidence arrives, a discharge plan that names the delirium, explains the likely recovery and arranges follow-up of cognition is a reasonable minimum.
- Record delirium clearly in the discharge summary.
- Explain to patients and families that recovery may take weeks or longer.
- Arrange follow-up of cognition after discharge.
- Ask about distressing memories of the delirium episode.
- Watch for unrecognised dementia once the delirium has settled.
Why it matters
Delirium care usually ends at discharge, though recovery often does not.
Don't overread it
A narrative review of few, varied studies; it cannot recommend any specific recovery intervention.
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