Introduction

The elderly often gets confused very easily. Confusion can occur suddenly (acute) or gradually (chronic). Confusional state can be caused by:

• Direct insult or injury to the brain such as head trauma, cerebrovascular disease, tumour.
• Indirect causes can be due to physical illness, infection, metabolic disturbances, intoxication, toxic or poisoning.
• Emotional disorders.
• Social causes such as moving house.

10 – 40% of elderly admitted to the hospital with acute confusion. About 10% of the elderly living in the community has chronic confusion.

Signs and Symptoms

You may suspect a person to have confusion if you noticed:

• A person becoming more forgetful or having problems remembering recent events.
• Having problems in concentration or focusing their attention when doing things, when answering questions and so on.
• A person starts to develop changes in their behavior such as starting to get more agitated or even becomes more aggressive.
• A person goes through changes in their mood sometime being very depressed or become happier than normal or a mixture of both at the same time or through other range of emotions.
• A person may start showing difficulties in doing activities which they are used to doing everyday.

You can look for more details on acute confusional states:

• As in delirium

You can look for more details on chronic confusional states:

• As in dementia

Complications

• Risk of injury to self and others
• Malnourished and dehydration from self neglect
• Getting lost
• Loosing your property
• Family discord

Treatment

Treatment can be:

• The caretaker
• The patient:
  • Non-drug
  • Your doctor may give you drugs to reduce the behavior and emotional problems

Prevention

• Practicing Healthy life style i.e. avoid smoking, eating well.
• Early detection and treatment of medical condition which can lead to acute and chronic confusion.
• Mental exercise- reading and keeping yourself active mentally.

Rehabilitation

For chronic confusion

• Validation therapy
• Reminiscence therapy and life review
• Reality orientation

Support Groups

NASCOM (National Council of Senior Citizens Organisations Malaysia)

AFDM(Alzheimer’s Disease Foundation of Malaysia) (www.adfm.org.my)

Persatuan Pesara Kerajaan Majlis Pusat Kebajikan Malaysia

Gerantology Association of Malaysia (http://www3.jaring.my/gem)