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Confusion is a disturbed thought process and may be either temporary or permanent. Confusion might manifest itself in inappropriate behavior, aggression, hallucinations, or simply just not knowing the present day, date or time. Confusion has many causes including severe pain, high fever, low blood sugar, alcohol withdrawal, lack of oxygen to the brain, too much calcium in the blood, tumor spread into the brain, or a side effect of narcotic medication. Many people become confused shortly before death.
What to look for:
- Appearance of drowsiness
- Seeming easily startled and frightened
- Rambling speech
- Inappropriate behavior
What to do:
- Report brief episodes of confusion (being lost or not knowing a familiar face).
- Take familiar items (a quilt, articles on a bedside table, a favorite picture, etc.) when changing locations. Keep a clock and a calendar nearby.
- Keep a night light in the bedroom and bathroom.
- Inform others, especially caregivers, of what might be confusing.
- Tell the patient who you are.
- Gently touch the patient and face her or him when speaking.
- Turn off television or radio.
- Talk slowly and use short sentences.
- Frequently orient patient as to day, time and place.
- Explain everything that you will be doing.
- Protect the patient from injury.
- Do not restrain the patient to bed or chair unless told and taught to do so by the nurse.
- Act in a calm manner and accept the person as she or he is.
- Expect to repeat the above steps frequently.
- Administer prescribed medications.
When to call hospice:
- At the very first sign of confusion or if confusion worsens
- If the confused patient becomes very aggressive
- If the confused patient appears to be in danger of harming himself or others
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