The guideline for the caring of active delirium patients is as follows:
Protect the patients and prevent them form injuring others, the keypoint is that of prevention of violence, not suicide.

1. Satisfying basic physiologic needs: including nutrition (in case lithium salt is taken, the patient should have sufficient intake of salt, rest, sleeping and personal health).
2. Arranging appropriate therapeutic environments, reducing stimulation in the environment, providing simple, placid environments.
   
3. Providing target-oriented activity arrangements, assisting participation in constructive activities to give issue to the patient’s excessive energies.
   
4. Setting limits to patient’s inappropriate behaviors by providing segregation or protection, restrictions, holdovers, or appeasement through expedient measures.
5. Endeavor to bring the patient’s attention on useful topics while holding talks with him, ignore or divert his impractical demand or delusions.
6. Being impartial in treating the patients and be consistent in your attitude, correct patient’s morose manipulating behaviors.
   
7. Promoting the patient’s preferred socialization process, increase senses of reality, increase personal supporting system.
8. Assisting the patients to identify what and how they really feel, to learn new respondent skills.
9. Teaching the patients to identify where the pressure comes from, and skills to perceive, handle with and prevent pressures.
   
10. Teaching patients to recognize the disease and side effects due to drugs prescribed to take care of the disease, and assist in continued use of drugs.

Nursing care of active delirium patients:

1. Physical aspects:
   (1) Assess the environmental security, remove dangerous articles and equipments, safeguard patient’s safety.
   (2) Provide sufficient food and water (easy to digest, portable high calorie, high protein, high vitamin food), to help maintain required nutrition and input/output equilibrium.
   (3) Arrange for a tranquil and undisturbed environment in which to eat the food.
   (4) Observe and be mindful if the patient is struck with excrementitious problems.
   (5) Maintain the integrality of the skin.
   (6) Assist to obtain adequate rest and sleep.
   (7) Assist to spruce up appropriately, maintain in shape, a neat appearance and in health.
   (8) Arrange for a non-stimulant and simple toned therapeutic environment to alleviate responsiveness to stimulation (see to it that the room temperature be just right, the incident light be not too strong, cool series of color is employed, the décor be soft tuned and delicate, the music that is being spread about the soft toned and of slow rhythmicity, the room is free of noises).
   (9) Restrict amount of activities (avoid overly sophisticated or competitive activities, adopt those which can be accomplished through the patient’s own efforts); for mild delirium cases the design may take a static note, such as “writing” or “painting”; or else the patients be taught with constructive activities or activities of which results can easily come by or involving larger scale limbal movements which would help to dissipate patient’s energies.
   (10) Observe signs portending an assault by the patient, such as: rigidified posture, restlessness, bluffing, voice turning louder, lack of toleration, verbal insinuation, and preconceive probable modes of attack or sabotage, take necessary preventive measure in time.
   (11) When the patient commits itself to sex exposure or provocative acts, take him away and give protection of him.
   (12) When lithium salt is prescribed, instruct the patient to be adequately informed as to the efficacy and side effects of the drug at the same time.
   (13) Assist the patient to input drugs on time and prevent him from hiding away the drugs himself.
   
2. Sentimental aspects:
   (1) Adopt a brief but repetitive interaction instead of long hours of discussion, build a therapy-based medical/patient relationship.
   (2) Support and be considerate for your patient with a kind, warm., friendly and unassuming attitude. Respond patient’s complaints with a calm but firm tone, but a neutral position, try to reason with facts instead of falling into disputes.
   (3) Communicate with a brief, clear-cut and unassuming bearing, speak in a low but composed tone; refrain from authoritative tonality, plain cajolery may be employed from time to time.
   (4) Put patient’s properties under appropriate custody and control.
   (5) When the patient is overly excited, try to switch his attention and by means of diversionary tactics bring him off the site, offer instead a quiet space clear and free of disturbances.
   (6) For a patient overly zealous about public affairs, it is not appropriate to assign him works involving much mental labor, or to ask him work for the medical staff (because patients of this disease are often unable to concentrate or work a longer while or make unreasonable request by considering himself a privileged person.
   (7) When the patient raises unreasonable or excessive request, the nurse may respond by feigning assenting to consider the request, but in fact apply the diversionary or procrastination tactics, or still keep the patient partially satisfied but may, if the situation warrants, put him under custody or restraint or even isolation.
   
3. Intellectual aspects:
   (1) When the patient comes up with bragging or delusive talks, don’t sneer at him or interrupt him. Nor strike a debate or question, chide his motivation.
   (2) Owing to inability to concentrate and to come to a judicious conclusion, the patient may put his delusions into writing, this should be safeguarded in time to prevent legal encumbrances or his proper interests from being prejudiced.
   (3) When the patient manifests sabotage or assailing initiatives, take him away and give him appropriate custody;
   (4) Assist the patient to observe ward rules.
   (5) Assist the patient to ascertain what he really feels and thinks, and to learn new skills with which to respond to oncoming situations.
   (6) In the beginning assist the patient to make decisions, by and by let the patient to make independent decisions or assume responsibilities all by himself.
   
4. Social aspects:
   (1) To prevent the patient from incurring trouble in a group, the nurse should impose restrictions as a precondition to his participating in group activities, and put him under segregation if obliged to.
   (2) When the patient falls in dispute with others, try not to call his name or take a threatening note, instead view his behavior as part of his disease and exhort him more preferable ways of handling the situation in a peaceful, friendly and polite manner.
   (3) Help the family to be better acquainted with the disease, and ask them to encourage the patient to continued, consistent drug intake.
   (4) Assist the patient to consistently input necessary drugs.
   (5) Strengthen the supporting system respecting the case.
5. Spiritual aspect:
   (1) Once the symptoms seemed relieved somewhat, strike a discussion and draft up future plans for the patient together with the patient.
   (2) Once both the patient’s self-respect and self-confidence are restored or built up, help him redefine guideline and orientation of his life ahead.
   (3) Where a patient is gifted with creative potentials help him to exploit himself in that domain.