Chapter 3: Symptoms and health concerns
Confusion – What can help
What their healthcare provider can do
How confusion is managed depends on many things including the cause of the confusion and the person’s goals for their care. For example, if their confusion is due to an infection, antibiotics may help. Alternatively, it might be decided that tests will
not be done, even if the problems causing the confusion might be reversible.
Click below to read some of the reasons tests might not be done.
- A person’s advance directive requests no further tests or treatments even for potentially reversible things like an infection.
- The patient does not wish to return to hospital no matter what. If treatment requires hospitalization, then the treatment is not possible.
- If the person’s death is expected within a few hours or perhaps a day or two, the confusion is often managed with medication.
For all of the above situations, it’s important to manage the person’s confusion to maintain their dignity, their safety, and the safety of those around them.
Considerations
When people who have an advanced illness become confused, it may indicate a life-threatening complication. Sometimes the cause can be easily and quickly sorted out and treated. It’s important to be aware that while efforts might be made to find and treat possible causes, the individual may not respond to treatment.
What families can do
Click below for some suggestions that might be helpful.
- Try to remain calm and speak slowly.
- Minimize challenges and tasks that will frustrate them, and subtly help with things that are too difficult or complex.
- If the person wears hearing aids or glasses, make sure these are available so the person can see or hear as well as possible.
- Limit the number of different people the person meets, particularly if visits make their anxiety or distress worse.
- Try to remind the person where they are and who you are.
- Avoid contradicting, disagreeing, arguing, or correcting the person. It’s generally best to acknowledge their concern and let them know they are safe.
- If the person is hallucinating but not frightened, it’s best to acknowledge them rather than to try to reorient them.
- Lighting should be bright enough to lessen the chance of shadows being confusing, but not so bright the person cannot rest.
- Keeping a clock, calendar, or their phone nearby may help remind the person of the time of day, date, month, or year.
- It may help to have some pictures or other things they enjoy near their bed.
