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Published: February 19, 1998

Confused elderly people

Only a small percentage of older persons become confused and disoriented, but they can present a challenge to family and other caregivers.

Confusion can be caused by many things. One is sickness. Weakness, fever or pain can all cause any person to become irritable, miserable or confused, regardless of their age. These feelings are not noticed as much in younger and middle-aged adults because they tend to have a quick bounce-back rate. But with older people their emotional state is often focused on, as if we expected it to be negative.

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Medications and anesthetic can cause confusion in any person, as I found out once. I don’t remember it myself, but my wife Ruth was by my side when I once came out of an anesthetic from an operation. She told me that I kept saying, “Oh, it’s nice to see you, again,” again and again and again.

With elderly people these upsets or periods of confusion tend to last longer. Older people generally take longer to recover from illness. The older you get, the slower your body bounces back from anything, whether it’s a cold, the flu, an infection or symptoms of long-term diseases of aging such as arthritis, rheumatism or diabetes. Prolonged confusion can also be a side effect of other serious conditions such as brain tumors or even malignant tumors. Poor hearing can also lead to a person appearing to others to be quite confused.

Another cause of confusion is Alzheimer’s disease, a tragic degenerative illness where the ability of the brain synapses to work is hindered by a physical deterioration, leading to a serious loss of current perception and memory. But it’s important not to jump to conclusions and pre-judge a person as being senile or demented just because they are confused.

A third cause of confusion is depression, something which too often goes undiagnosed because the elderly person doesn’t want to see a doctor. If any of us experienced a severe physical pain in any part of our body, it wouldn’t be very long before we were in our doctor’s office. But emotional pain, such as depression, is not usually recognized at first. The symptoms that come with it, a lowering of mood, a lack of physical energy and a lowering of initiative and self-esteem, tend to hinder people from seeking help right away. This is especially true with the elderly, who are often afraid they are losing their mind or going senile.

If a person becomes confused, they need one thing right away – a visit to their doctor who can assess which may be happening, and either provide the appropriate medicine or refer the person to the correct specialist for further evaluation.

All of us can help a confused person in many ways. We can slow down our rate of speech and speak more clearly. We can maintain a calmness in our voice. If we appear anxious they will become anxious as well, and this will add to their confusion. If you are a caregiver for a confused person, explain what you are doing and why, in simple terms, especially if you are going to touch them. Being touched without warning often creates anxiety and fear.

Allow the confused person extra time to think about or process what you are saying. Get their attention. Eye to eye contact can be helpful. And most important, see that a person who becomes confused gets professional help and assessment at the beginning of any problems with confusion.

To contact any of our column experts, except Dr. MacInnis, please send a letter to the columnist, care of The Western Producer, Box 2500, Saskatoon, Sask., S7K 2C4. The paper will forward your letters unopened.

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