Practical guidance

Choosing a delirium assessment tool

There is no single “best” tool — the right choice depends on the clinical question, setting, patient population, administration and available training. Start with these questions, then use the directory filters to examine relevant tools.

No single instrument is endorsed. Check the evidence, instructions, training requirements and permissions for any tool you are considering. Local guidelines and available training should guide the final choice; see Methodology and Disclosures.

1. What are you trying to do?

Episodic assessment

Find structured tools for first presentation or another time when delirium is suspected.

See episodic assessment tools Observe serially

Find instruments intended for repeated observation across a shift or episode of care.

See serial-observation tools Measure severity or course

Find instruments that grade severity or track change over time.

See severity tools Estimate future risk

Find named models that estimate who may develop delirium later, kept separate from current assessment.

See prediction models

2. Where are you, and who is the patient?

Setting and population change which tools are suitable and practical. Start with a common route, then inspect each profile and its source population.

General or acute hospital Emergency department Intensive care Perioperative care Children and young people Palliative care Family or caregiver information
Open all directory filters How the taxonomy works
Principles that matter more than the exact tool

Getting detection right

  • Select carefully and use consistently. Choose an assessment validated for the relevant population and setting, then follow its current instructions.
  • Assess risk and observe systematically. When indicators of delirium are present, use an appropriate validated assessment in line with local guidance; a negative result does not override clinical concern. Hypoactive delirium is easily missed.
  • Notice abnormal arousal. Altered arousal can support assessment, but it is not synonymous with delirium and requires clinical interpretation.
  • Interpret every result clinically. A result indicating possible delirium prompts assessment for delirium and its causes; a negative result should not overrule continuing concern.
  • Match the tool to the rater. Use instruments for which staff have read the instructions and are competent; some require a formal training process and others do not.
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