Caregiver Tips on Managing Confusion in Alzheimer's Disease
People with Alzheimer’s disease are inclined to become more and more confused as the disease progresses. You cannot stop the confusion as it results from the devastating damage that is occurring in the brain. However, you can help to reduce confusion and the fear and anxiety that frequently accompanies it.
Confusion is defined as a disturbed mental state in which the person has impaired orientation with respect to time, person and place. In the earlier stages of Alzheimer’s someone may get confused about what an object is for or they may get lost because they are no longer able to recognize streets. In the later stages of Alzheimer’s the ability to identify where they are, who they are, what they are doing, who the people are around them and why those people are doing things for them and to them increases. It is not difficult to imagine just how perplexing and frightening that can be.
Tips to Help Manage Confusion
- Improve communication. Speak clearly, concisely and in a friendly way.
- Have familiar objects and personal possessions in their room.
- Simplify their room and shared rooms by removing unnecessary objects. This encourages maximum, safe, mobility in familiar surroundings.
- Have a large chalkboard with short simple reminders of day of the week, any activity with time of day.
- Have large clear sign on bathroom.
- Try to keep room temperature between 21 °C to 23.8 °C (70F-75F) for comfort and to increase alertness and mobility.
- Insure good, safe lighting for rooms and when in outside areas. Provide a night light and try to reduce shadows as is practical.
- When you talk to a confused person make sure your face is visible so that they can see who you are and can see your facial expression.
- Explain what you are going to help them with. You may need to remind them who you are and who others involved in the activity are.
- Identify and correct sensory impairments; ensure patients have their glasses, hearing aid and dentures.
- Consider whether an interpreter is needed or use a regular caregiver with the appropriate language skills for people from other countries.
- Try to have familiar caregivers attend to their needs to encourage a feeling of security and orientation.
- Reduce noise and distractions as sensory stimulation can increase confusion.
- Familiar music of the type enjoyed by the person can assist relaxation and create a good atmosphere for teaching or interactions with caregivers or others.
- De-personalization will increase confusion. Include the person in decision making whenever possible. Feeling you have some control over your environment is very important for maintaining skills, interest and for self esteem.
- Encourage self care and encourage feedback, i.e. are you comfortable?
- Established routines will help reduce confusion.
- Arrange activities and treatments to allow long periods of uninterrupted sleep.
Every person with Alzheimer’s is an individual, so as a caregiver you have to try different approaches for dealing with their confusion. If you have found any technique of particular use do share your successes with us at OurAlzheimer’s.com.
Christine Kennard wrote about Alzheimer’s for HealthCentral. She has many years of experience in private and public sector nursing care homes for people with dementia. She has worked in a variety of hospital, public and private health settings and specialized in community nursing. Christine is qualified in group analytic psychotherapy, is registered in general and mental health nursing and has a Masters degree.