Confusion

When the thought process is disturbed, or when a person has trouble thinking and acting like they normally do, they may be confused. Many things can cause confusion, including:

  • Low blood sugar
  • Infection
  • High fever
  • Cancer spread into the brain
  • Cancer in the fluid around the brain
  • Lack of oxygen to the brain
  • Anemia (See the section called “Anemia.”)
  • Too much calcium in the blood
  • Intense pain
  • Too much pain medicine
  • Other medicines

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 cancer team right away. The patient may need to be seen 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’s 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 they were able to manage alone before
  • Cloudy, disorganized thinking or the patient not knowing where they are
  • Sudden changes in emotion; for instance, quick shifts from happy to irritated
  • Forgetting what they are doing

What the patient can do

  • Call your cancer team 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 appointments with the patient so that you can describe the patient’s problems and remember instructions for them.
  • Focus attention by gently touching the patient and facing the patient when talking to them.
  • Stay within a few feet of the patient when you’re talking to them.
  • 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 and time, and where they are.
  • 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 they are.
  • 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 hand washing, going to the bathroom, bathing, and other daily activities that may be hard for them to do alone.
  • Check to see what the patient eats. (They may forget to eat, or may not be able to eat.)
  • Be sure that the patient takes the right medicines the right way.
  • Keep medicines out of reach between doses.

Call the cancer team if the patient:

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

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Medical Review: June 8, 2015 Last Revised: June 8, 2015

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