Symptom Management

Confusion

Confusion is an aspect of delirium, which is common, especially in patients with advanced disease. Patients with a progressive medical disease often develop confusion or drowsiness before death.

Delirium can be caused by:

	Complications of the disease (e.g., organ failure)
	Medications
	Nutritional deficiencies
	Other disorders that affect the brain

Some signs of delirium include:

	Memory impairment or confusion
	Change in mood
	Illusions or hallucinations
	Agitation
	Disturbance in the sleep/wake cycle
	Fluctuating level of consciousness
	Disorientation to place, time, and/or person

Management of delirium can include:

	Medications (e.g., haloperidol, methotrimeprazine, thioridazine, chlorpromazine)
	General support for and communication with the patient and family
	Encouraging the family's interaction with the patient
	Any treatment that can help reverse the underlying cause