No. Delirium is caused by physical illness, injury, surgery or medicines. Delirium can be difficult to recognise. Families should not blame themselves for not knowing what it was.
Nearly every family asks some version of this, and usually not out loud. We should have visited more. We should have pushed harder with the doctor. We noticed she was not herself last Tuesday and did nothing about it. We let him have the operation.
Was it the operation?
Agreeing to an operation that was needed is not a mistake. Delirium afterwards is a known complication of surgery in older people, not the result of a wrong decision.
The same goes for hospital admission. Hospital wards do make delirium more likely, and that is a fair criticism of how wards are run. But getting someone treated for the condition that made them ill was the right call.
Why delirium is so often missed
Delirium is often missed, even in hospital and even by experienced staff. A short delirium test can help staff recognise it.
There are several reasons why it is missed. Delirium comes and goes, so anyone who sees the person during a good hour sees nothing wrong. The commonest form is the quiet one, where someone is withdrawn and sleepy rather than agitated, and quiet patients do not attract attention. And the early signs look like ordinary tiredness, or old age, or simply being somewhere unfamiliar.
If you raised it and were not listened to
Some families do notice, say something, and are not listened to. If that is what happened, the failure was not yours. Say it again, to a different person, and use the word: this is not how she normally is, and I think it might be delirium.
What you can do now
Tell the team what normal looks like for this person, because they have no way of knowing. Be there when you can. And make sure the word delirium is in the discharge letter and known to their usual doctor, because a past episode is one of the strongest warning signs for another one.
The illness caused this.
When to get help
Delirium (acute confusion) is a medical emergency. Outside a care setting, call local emergency services now. In a hospital, care home or nursing home, tell staff immediately. Say what has changed and ask whether it could be delirium.