Confusion is when one is unable to think or process thoughts with normal swiftness or lucidity. It is often accompanied by feelings of disorientation. The patient may experience difficulty focusing their attention on anything.

Other names for the condition are disorientation or decreased alertness.

Possible causes

    • Confusion in an elderly person is often linked to illness and may often first occur during hospitalisation. Alzheimer's disease is also a cause of confusion

    • High levels of toxins in the blood as a result of kidney or liver failure

    • Thyroid problems

    • Intoxication from alcohol or drugs

    • Low blood sugar

    • Head trauma/ injury, such as concussion

    • Reduced blood flow as a result of cardiac problems such as heart failure, coronary heart disease or irregular heart beat

    • Diabetes

    • Fluid and electrolyte imbalances and nutritional deficiencies

    • Often people who are running a fever or hypothermia

    • People with lung disorders who subsequently have low levels of oxygen

    • Certain medications: a combination of alcohol and medicine, abuse or misuse of medicines or alcohol, intoxication or withdrawal from drugs

    • Depression, schizophrenia and other mental health disorders

    • An infection such as: sexually transmitted infections, (specifically syphilis and HIV); a brain abscess; encephalitis; meningitis; sepsis

    • People who have a brain tumour

    • Asthma or COPD if there is a decrease in oxygen or an increase of carbon dioxide in the blood

    • Sleep deprivation

    • Head injury or concussion

    • If there is a decreased blood flow to the brain, as can happen with a stroke

    • In younger people, Reyes syndrome can lead to confusion

Home care/ Self treatment

A person who is confused should not be left alone. They should be put into a calm, quiet environment which may ease the confusion. The level of confusion should be tested by asking questions such as their name, age and so forth.

One should always introduce yourself to the patient each and every time you see them and keep the person up to date by means of calendars and clocks in the room. It is advisable to remind them regularly where they are, the plans for the day and so on.

If the confusion is due to low blood sugar, make sure they drink something sweet to regulate their blood sugar levels, but if the confusion lasts for more than 10 minutes, you should call a doctor.

When to call a doctor

It's important to seek medical assistance if:

    • The confusion comes on abruptly

    • If it's accompanied by other symptoms such as a headache, dizziness or if the person is feeling faint

    • If the person has a rapid pulse, slow/rapid breathing, has cold or clammy skin or an uncontrolled shivering or fever

    • The person is diabetic

    • The person has recently suffered a head injury or concussion

    • The person becomes unconscious

It's also important to inform the doctor about other symptoms which occur during the episodes of confusion, as this can help them get to the root of the cause.

What to expect at the doctor

A doctor will perform a thorough physical examination and may carry out neurologic tests and cognitive tests. This may include an MRI of the head, blood and urine tests and an EEG.


The type of treatment is dependent on the cause of the confusion.

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