Chapter 6: ICU Delirium

Before Rick’s esophagectomy and subsequent 8 week stay in Duke University Hospital ICU, I’d never heard of “ICU delirium” or any other kind of delirium brought on by hospitalization. 

It was heartbreaking to witness.

Honestly, his delirium reminded me of reading about POWs who had been physically tortured and mentally tormented by sleep deprivation and constant noise.  He had vivid hallucinations. He was paranoid, fearful, antagonized, and the delirium compounded his physical suffering.

Physicians do not see delirium as particularly life-threatening.  So, it takes a backseat to other critical issues, and that makes sense.  They will be focused elsewhere.

It’s up to you to advocate for your loved one here. Work with the nursing team.  Ask them: “What can be done to prevent or treat delirium?” Ask for a review of medication. 

Tips from the White Coats to Help with Delirium

  • Preserve the sleep cycle as much as possible. During the day, try to stay awake. At night, turn off the TV, darken the room, ask for quiet and try to sleep.
  • It helps a patient sleep if a familiar person is in the room at night. If the family advocates are available, it’s comforting to the patient for an advocate to stay with them overnight, instead of a hospital sitter.
  • Family members and visitors can do wonders to help keep the patient grounded in reality. While they try to keep the patient awake during the day, music, conversation, card-playing, other games, or something as simple as their touch make a difference.


Vanderbilt University has been studying ICU delirium for nearly twenty years and is a part of the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center. Dr. Wes Ely, a pulmonologist and professor of medicine and critical care at Vanderbilt University Medical Center in Nashville, Tennessee, considers ICU delirium a “massive public health problem.”

Click below for more information:

Delirium in the intensive care unit – PubMed (

Delirium in critical care patients : Nursing2020 Critical Care (