Confusion is a disorder of consciousness that causes impaired perception, decreased performance, and impaired concentration. Confusion can be a slowly increasing process or it can occur suddenly and acutely. Confusion often affects the elderly.
What is confusion?
Confusion can be a slowly increasing process or it can occur suddenly and acutely. Confusion often affects the elderly. Confusion is manifested by a disorientation accompanied by inner restlessness and impaired memory. This can lead to perceptual and concentration disorders, as well as a drop in performance. In most cases, those affected suffer from a limited ability to react. In some cases, the affected persons are very sleepy or become aggressive. Increased confusion often occurs at night. Long-term memory is not usually affected by confusion. Symptoms may increase in a slow process or may occur suddenly. If the onset of confusion is acute and abrupt, the cause should be medically determined and appropriate treatment should be given.
Causes
Confusion can have many causes. Harmless causes may be responsible, such as low fluid balance in the body. Various medications can also cause confusion as a side effect. Poisoning, such as after drinking too much alcohol, can also result in confusion. However, a whole range of serious diseases can also be possible triggers. Arteriosclerosis, brain injuries and heart failure can cause confusion, as can diabetes, encephalitis or meningitis. Epilepsy, strokes or brain tumors can also cause confusion. Especially in elderly people, dementia, for example Alzheimer’s disease, is often responsible for confusion. Sometimes confusion can also occur due to febrile infectious diseases or urine poisoning. In addition to these physical causes, sometimes social causes, such as losing a caregiver or lack of social contact, also trigger confusion.
Diseases with this symptom
- Arteriosclerosis
- Concussion
- Brain tumor
- Dementia
- Heart failure
- Diabetes mellitus
- Stroke
- Alzheimer’s disease
- Encephalitis
- Encephalitis
- Epilepsy
- Infectious diseases
Diagnosis and course
In the case of existing confusion, it is important to clarify, before performing examinations to establish the diagnosis, since when the confusion conditions exist, what underlying diseases are present, what medications are taken and whether the fluid intake is sufficient. In addition, the mental stress of the affected person is clarified. After the basic assessment, blood tests, blood glucose and blood pressure measurements are part of the basic program of examinations. Possible neurological deficits are also checked by reflex and eye examinations, as well as testing of the sense of balance. Depending on the suspected cause, the necessary examinations for the respective underlying disease are performed. If no organic causes can be determined, a psychiatric examination should be performed. The course of the disease always depends on the causes. If the confusion occurs, for example, due to medication or insufficient fluid intake, it is relatively easy to treat. With more serious underlying conditions, the course of confusion may not be able to be stopped, but at best slowed.
Complications
In confusion, it is difficult to predict the complications that might occur. These always depend on the mental and physical state of the affected person and the severity of the confusion. This very often occurs in elderly people and can lead to the person finding themselves in a place or with people they do not know. Such behavior not infrequently leads to panic attacks and outbursts of anger. In the worst case, the person can also hurt himself if the confusion is very advanced.This is often accompanied by headaches and forgetfulness, and those affected are often no longer able to distinguish between strangers and familiar people. Confusion is treated either by a psychologist or by medication. Confusion is also often part of the aging process and occurs in almost all people. No complications occur during treatment, as it is usually a purely psychological treatment. Assisted living is often organized for those affected, as they can no longer cope with their own lives and are a danger to themselves and others. In most cases, confusion cannot be completely eliminated from the sufferer’s life.
When should you see a doctor?
Confusion can be as harmless as it can be dangerous. To determine whether a person’s confusion needs medical attention, it is important to know how long it has existed and what symptoms accompany it. If the affected person was completely lucid until a short time ago and now seems confused, there could be many reasons behind it, from a stroke to a brain hemorrhage to low blood pressure with the threat of fainting. Sudden confusion is always an alarm signal, the affected person should be calmed down as much as possible and either driven to the doctor or taken there by ambulance. If drugs or medication were involved, there is a risk that the patient will develop other symptoms in addition to confusion or possibly become aggressive, so this is also a case for the doctor. In old age or with diseases of the nervous system, temporary or permanent confusion may be normal. Nevertheless, if a diagnosis is known, a medical examination should be performed if there is any change in a person’s usual confusion. There could be a change in the underlying disease, which is manifested by increasing or sometimes even decreasing confusion. Normal and rather secondary confusion is when the patient has just experienced a significant physical injury or shock, or has been subjected to great mental stress. In such situations, he or she should receive an all-around medical examination anyway.
Treatment and therapy
As varied as the causes of confusion can be, so are the treatment options. If confusion is due to medication, the medication in question must be discontinued and replaced with another. If a lack of fluids is the cause of the confusion, adequate fluid intake must be ensured. If the fluid deficiency is already very advanced, infusion therapy in the hospital is sometimes necessary. In the case of psychological triggers, caring nursing of the affected person is important, in which care should be taken to eliminate as far as possible all stress factors for the sufferer. If the confusion is a concomitant of an underlying physical illness, therapy is based on the disease at hand.
Outlook and prognosis
Confusion can lead to various complications and can affect the patient’s life differently. If the confusion is temporary, it is a harmless symptom that does not require further attention. Confusion can occur mainly during the consumption of alcohol and other drugs, or during the course of a severe flu. This usually disappears by itself. In most cases, confusion in the elderly occurs in the course of an illness. It cannot be treated specifically, so after a while the patient may be dependent on help from other people and need permanent care. It occurs mainly in patients with dementia or Parkinson’s disease. In some cases, confusion occurs after accidents or after epileptic seizures. This can also only be combated to a limited extent with medication. However, it cannot be ruled out that confusion will accompany the patient’s entire life. It usually reduces the quality of life and in some cases may lead to accidents or negligent behavior.
Prevention
Confusion can sometimes be prevented by specific prevention. For example, especially in the elderly, a lack of fluids is often responsible for confusion. This can be counteracted by an adequate intake of fluids. Likewise, attention should be paid to a balanced and vitamin-rich diet.In older people, psychological and social causes are often also the triggers of acute confusion. This can be counteracted to a certain extent by specifically involving the elderly patients in social contacts and activities. Careful psychological support for those affected, social contacts, and shared activities are good preventive measures when losses of caregivers are the cause of confusion.
What you can do yourself
For good management of confusion in everyday life, the focus (if possible) is on causal treatment. Since a lack of fluids can promote confusion, especially in the elderly, make sure to drink enough. Water and tea are particularly suitable for this purpose. An adequate and healthy diet can also help to reduce further complications (for example, due to malnutrition) and improve the general quality of life. In the case of severe confusion that occurs regularly or lasts for a long time or permanently, the support of another person in everyday life can be useful. It depends on the individual case whether this requires a trained caregiver and whether the supporting person has to be present all the time. Some affected persons tend to leave the house independently in their confusion and get lost in the process, so that they can no longer find their way back on their own. In this case, it can be useful to carry a piece of paper with your own address and a telephone number. Such a note should be kept in a place where it is easily accessible. In most cases, it is helpful if those affected have a trusted contact person at their side – regardless of how much help is actually necessary and desired. If necessary, this person can keep an eye on how the confusion develops in the long term and whether appropriate measures are needed.
