Books
Books and longer writing about delirium. The 4AT Manual was published on 31 July 2026. The complete PDF and EPUB are free to read or download from the4AT.com, with no registration. Kindle, paperback and hardback editions are also available through Amazon. A guide for patients, families and carers follows in November 2026. Chapter 1 of that guide is free to read now.
The 4AT Manual
Published 31 July 2026
The 4AT Manual: A Practical Guide to Delirium Assessment
By Professor Alasdair MacLullich
The 4AT Manual is a practical guide to using the assessment consistently and acting on its results.
The 102-page print edition includes thirty worked clinical cases. It is written for nurses, doctors, allied health professionals, students and educators.
Choose a free PDF or EPUB, or a paperback or hardback from Amazon. The content is the same in every edition.
What the manual covers
- Why the 4AT was developed, and its role in delirium assessment.
- How to administer and score each of the four items.
- How to interpret the result and decide what to do next.
- Worked clinical cases from a range of settings.
- Common difficulties, special circumstances, and audit.
- An overview of the supporting evidence.
It is written for nurses, doctors, allied health professionals, students, educators, researchers, and teams implementing delirium pathways or electronic health records.
Editions and licence
- Title
- The 4AT Manual: A Practical Guide to Delirium Assessment
- Author
- Professor Alasdair MacLullich
- Edition
- First edition, manual version 1.0, 2026
- Publisher
- Delirium Support Press
- Free editions
- PDF and EPUB from the4AT.com, with no registration.
- Paid editions
- Kindle, paperback (ISBN 978-1-918164-00-8) and hardback (ISBN 978-1-918164-05-3) from Amazon. Each link selects a local Amazon store.
- Licence
- Except where otherwise stated, the manual's text, tables and original diagrams are licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). The 4AT oval logo, cover artwork and design, and separately credited third-party material are excluded. The licence permits reuse and adaptation of the licensed content, including translation, with attribution; see the manual's full copyright and reuse terms.
Page reviewed 21 September 2026.
Delirium (Acute Confusion): A Family Guide
Publishing November 2026
Delirium (Acute Confusion): A Family Guide to Sudden Changes in Thinking and Memory: Includes advice for people living with dementia
By Professor Alasdair MacLullich and Dr Sharmella Summan
A guide for people who have experienced delirium, and for families and carers trying to understand a sudden change in someone they know. It explains what delirium is, what families might see, how clinical teams assess and treat its causes, ways relatives and carers can help, and what recovery can be like.
Chapter 1 is free. Enter your email address on the book website, deliriumfamilyguide.com, and a link to the PDF will be emailed to you.
While the book is in preparation, Delirium Support provides practical information about sudden confusion, getting help, delirium and dementia, supporting someone, and recovery.
About the authors
Alasdair MacLullich is a hospital doctor and Professor of Geriatric Medicine at the University of Edinburgh. For more than 20 years, he has cared for people with delirium and researched the condition. He created the 4AT, a delirium test used in hospitals worldwide.
Sharmella Summan has worked as a doctor in hospitals and general practice, and now works in a hospice. She has cared for many people with delirium and has experienced delirium herself as a patient. She tells her own story in this book.
Enquiries
For media or publishing enquiries, please use the media and speaking page. For information about delirium, use the delirium overview, the4AT.com for professionals, or Delirium Support for patients, families and carers.