Introduction —
This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.
The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.
Links to related guidelines are provided separately. (See "Society guideline links: Cognitive impairment and dementia".)
International
●Improving perioperative brain health – An expert consensus review of key actions for the perioperative care team (2021)
●Pan-American and Iberian Federation of Societies of Critical Medicine and Intensive Therapy (FEPIMCTI): Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients (2020)
●Society of Critical Care Medicine (SCCM): Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU (2018)
●Clinical practice guidelines for delirium management − Potential application in palliative care (2014)
●International Group of Researchers and Clinicians (INCOG): Recommendations for management of cognition following traumatic brain injury, Part I − Posttraumatic amnesia/delirium (2014)
Canada
●Choosing Wisely Canada: Avoid the use of physical restraints to manage behavioural symptoms of delirium and dementia (BPSD) (updated 2022)
●Choosing Wisely Canada: Don't use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium (updated 2022)
●Choosing Wisely Canada: Don't routinely obtain head computed tomography (CT) scans, in hospitalized patients with delirium in the absence of risk factors (updated 2021)
●BC Guidelines: Palliative care for the patient with incurable cancer or advanced disease − Part 2: Pain and symptom management (2017)
●Canadian Coalition for Seniors' Mental Health (CCSMH): Guideline for the assessment and treatment of delirium, update (2014)
United States
●Society for Post-Acute and Long-Term Care Medicine (AMDA): Choosing Wisely – Don't recommend aggressive or hospital-level care for frail individuals without a clear understanding of the individual's goals of care and the possible benefits and burdens
●AMDA: Choosing Wisely – Don't routinely prescribe or continue sedative hypnotics such as Restoril or Ambien, diphenhydramine (Benadryl), benzodiazepines, or Serotonin Modulators (Trazadone) for long-term treatment of sleep disorders in geriatric populations. Consider the use of nonpharmacological interventions (e.g., physical activity, a regular schedule or cognitive behavioral therapy)
●American Psychological Association (APA): Guidelines for psychological practice with older adults (2014, updated 2022)
●American Geriatrics Society (AGS): Clinical practice guideline for postoperative delirium in older adults (2014, reaffirmed 2021)
●American Heart Association (AHA): A scientific statement on older adults in the cardiac intensive care unit – Factoring geriatric syndromes in the management, prognosis, and process of care (2020)
●American College of Radiology (ACR): ACR Appropriateness Criteria on acute mental status change, delirium, and new onset psychosis (2018)
●American College of Critical Care Medicine (ACCM): Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit (2013)
Europe
●European Society of Anaesthesiology and Intensive Care Medicine (ESAIC): Evidence-based and consensus-based guideline on postoperative delirium in adult patients, update (2024)
●European Society of Medical Oncology (ESMO): Clinical practice guidelines on delirium in adult cancer patients (2018)
United Kingdom
●Healthcare Improvement Scotland (HIS): Scottish palliative care guidelines – Delirium
●National Institute for Health and Care Excellence (NICE): Clinical guideline on delirium – Prevention, diagnosis and management in hospital and long-term care (2010, updated 2023)
●Scottish Intercollegiate Guidelines Network (SIGN): A national clinical guideline for risk reduction and management of delirium (2019, revalidated 2022)
●Centre for Perioperative Care (CPOC) and British Geriatrics Society (BGS): Guideline for perioperative care for people living with frailty undergoing elective and emergency surgery (2021)
●BGS: End of life care in frailty – Delirium (2020)
●BGS: Comprehensive geriatric assessment toolkit for primary care practitioners – Patients presenting with confusion and delirium (2019)
●NICE: Quality standard for care of dying adults in the last days of life (2017)
●NICE: Quality standard for transition between inpatient hospital settings and community or care home settings for adults with social care needs (2016)
●NICE: Guideline for care of dying adults in the last days of life (2015)
●NICE: Guideline for transition between inpatient hospital settings and community or care home settings for adults with social care needs (2015)
●NICE: Quality standard on delirium in adults (2014)
Australia–New Zealand
●Australian and New Zealand Society for Geriatric Medicine (ANZSGM): Position statement on delirium in older people (2005, revised 2021)
●Australian Commission on Safety and Quality in Health Care (ACSQHC): Delirium clinical care standard (2021)
●Choosing Wisely Australia: Do not continue benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review (2018)
●Choosing Wisely Australia: Do not prescribe benzodiazepines or other sedative-hypnotics to older adults as first choice for insomnia, agitation or delirium (2016)
●Choosing Wisely Australia: Do not use physical restraints to manage behavioural symptoms of hospitalized older adults with delirium except as a last resort (2016)
Japan
●[In English] Japanese Psycho-Oncology Society (JPOS)/Japanese Association of Supportive Care in Cancer (JASCC): Clinical guidelines for delirium in adult cancer patients – A summary of recommendation statements, revised (2023)
●[In Japanese] JPOS/JASCC: Clinical guidelines for delirium in adult cancer patients, 2nd edition (2022)
●[In Japanese] Japanese Society of Intensive Care Medicine (JSICM): Japanese guidelines for the management of pain, agitation, and delirium in intensive care unit (J-PAD) (2014)
