When the thought process is disturbed, or when a person has trouble thinking and acting like he normally does, he may be confused. There can be many causes of confusion, including:

• Low blood sugar
• Infection
• High fever
• Tumor spread into the brain
• Cancer in the fluid surrounding the brain
• Lack of oxygen to the brain
• Too much calcium in the blood
• Intense pain
• Too much pain medicine

Confusion can start or get worse when the patient goes to a new place and may worsen at night. Usually the cause of the confusion can and should be treated.

If a person becomes confused, call the doctor right away. The patient may need to see the doctor quickly so the cause of the problem can be found and treated. Sometimes, the patient may need to be in the hospital until the problem is treated. During this time, it is helpful for confused patients to have someone they know stay with them.

What to look for

• Sudden change in ability to speak, especially long pauses or slurred words
• Trouble staying alert or paying attention
• Patient needs help bathing and dressing when he was able to manage alone before
• Cloudy, disorganized thinking or a patient not knowing where he is
• Sudden changes in emotion, for instance, quick shifts from happy to irritated
• Forgetting what he is doing

What the patient can do

• Call the doctor right away if you realize you are having periods of confusion.
• Ask someone to stay with you to help keep you safe.

What caregivers can do

• Go to doctor's appointments with the patient so that you can describe the patient's problems and remember instructions for him.
• Focus attention by gently touching the patient and facing the patient when talking to him.
• Stay within a few feet of the patient when you are talking to him.
• Always tell the patient who you are.
• Turn off the radio or TV when you are talking.
• Talk slowly and use short sentences.
• Tell the patient the date, time, and where he is.
• Keep a calendar and clock where the patient can see them.
• Tell the patient just before you start doing something (such as changing the bed, dressing, or bathing them) and explain each step as you go along.
• Play soft, soothing music when the patient is in the room alone.
• Use a night-light so that the patient can see where he is.
• Label commonly used items with pictures. For example, put a picture of a toilet on the bathroom door and a picture of a flame over the stove.
• Protect the patient from injury.
• Help the patient with washing, going to the bathroom, and other daily activities that may be hard for him to do alone.
• Check to see what the patient eats. (He may forget to eat, or may not be able to eat.)
• Be sure that the patient takes the right medicines as prescribed.
• Keep medicines out of reach between doses.

Call the doctor if the patient:

• Becomes confused suddenly or if confusion worsens
• Has any sudden changes in his ability to do routine tasks or care for himself
• Becomes violent
• Hurts himself in some way

Go back to Caring for the Patient with Cancer at Home: A Guide for Patients and Families.

Last Medical Review: 04/27/2009
Last Revised: 04/27/2009