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About this site and the book
Delirium often comes with no warning, and most families do not know its name when they first see it. This site explains the condition in plain English and sets out what families can do.
It is written for family members and carers, and for people who have had delirium and want to make sense of what happened. It is not a medical textbook, and it is not a substitute for the clinicians looking after your relative.
Who writes it
This site is written by Professor Alasdair MacLullich, Professor of Geriatric Medicine at the University of Edinburgh and a consultant physician at the Royal Infirmary of Edinburgh. He has worked as a doctor since 1993, with delirium as his main research and clinical focus since 2005.
His work on delirium includes:
- Designing the 4AT (2011, with Dr Tracy Ryan and Dr Helen Cash), a two-minute bedside test for delirium now used across the world. It has been validated in 33 diagnostic-accuracy studies involving more than 6,000 patients, translated into more than 20 languages, and UK national (NICE) guidance in 2023 named it the best option for most settings.
- Co-founding the European Delirium Association (2006) and co-founding World Delirium Awareness Day (2016).
- Founding the Scottish Delirium Association (2011).
- Co-chairing the Scottish national (SIGN) guideline on delirium (2019).
- Serving as Editor-in-Chief of Delirium, the specialist research journal.
- More than 200 published research outputs, and hundreds of talks, webinars and workshops on delirium, including more than 100 international presentations.
Links: the4at.com · University of Edinburgh profile · ORCID 0000-0003-3159-9370
The book
Delirium (Acute Confusion): A Family Guide to Sudden Changes in Thinking and Memory. Includes advice for people living with dementia is a detailed, book-length guide to delirium written for families and carers. It is coming soon.
Professor MacLullich is writing the book with Dr Sharmella Summan. She has cared for people with delirium as a doctor and experienced severe delirium herself while in intensive care. Her account appears early in the book.
The book runs from the fundamentals (what delirium is, its causes, diagnosis, treatment and prevention) through the experience of delirium, hospital care, raising concerns with staff, recovery, delirium in the ICU, in care homes and at the end of life, to the relationship between delirium and dementia. It closes with a quick action guide, a glossary and the questions families ask most.
How this site is written and checked
The content is drawn from the book, from UK national guidance (the SIGN 157 and NICE CG103 delirium guidelines), and from the international research literature. Every page shows the date it was last reviewed. Where evidence is uncertain, the pages say so; where numbers are given, they are rounded honestly (“about 1 in 4”) rather than dressed up as precision.
This site carries no advertising and no sponsorship. It uses Google Analytics only if you accept the cookie banner (see Privacy); there are no advertising cookies, no pop-ups, and no requests for your email address. It sells nothing except, in time, the book. The authors may receive royalties from the book, but everything on this website is free to use and is not conditional on buying it.
What this site cannot do
Everything here is general information. It cannot tell you what is wrong with your relative, whether their medicines are right, or when they will recover. Advice about an individual person can only come from the clinicians looking after them: the ward team in hospital, and their own doctor at home. If someone has become suddenly confused or unusually drowsy, get medical help now.
Contact
The best routes are the Delirium Support Facebook page, X (Twitter) or LinkedIn. Please do not send questions about an individual patient; for those, speak to the ward team or their doctor, and see Resources and helplines for UK support lines and specialist information that may be useful wherever you live.