| Assessments | Hypoactive-Hypoalert | Hyperactive- Hyperaltert | Mixed |
|---|---|---|---|
| Level of alertness | Lethargic, falls asleep between questions, difficult to arouse | Overly attentive to cues | Alternates between hyperalert and hypoalert states within hours or days |
| Motor activity | Decreased activity | Moves quickly | Alternates within one episode of delirium |
| Ability to follow commands | Follows a simple command, e.g., lift your foot Is passively cooperative | May be combative, pulls at tubes, tries to climb out of bed | Alternates between hypoactive and hyperactive states, may be unpredictable |
| Thinking Ability | Difficulty in focusing attention, disorganized | Easily distracted, rambles May mumble, swear, or yell | Alternates between hypoactive and hyperactive states in an unpredictable manner |
Source: Adapted from Forrest, J., Willis, L., Holm, K., Kwan, M. S., Anderson, M. A., & Foreman, M. D. (2007). Recognizing quiet delirium. American Journal of Nursing, 107(4), 35–39.