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Interacting with Someone Who Is Confused
Identify causes of immediate confusion and seek immediate help. If someone is suddenly and unjustifiably confused, they are experiencing delirium. This is an emergency situation. There are many medical complications that can cause confusion. How you treat confusion may depend on the underlying cause(s). Common health issues that may lead to immediate confusion include: Head trauma or injury, including concussion Low oxygen levels Medication side effects Nutritional deficiencies Seizure disorders Stroke Heat stroke or hypothermia
Repeat information frequently when someone is confused. Introduce or identify yourself to the person, even if you’ve known them for years. People who struggle with general confusion, dementia, delusions, or Alzheimer’s often require reintroductions, so always reiterate who you are and why you’re there. Many people suffering from confusion become frightened, which may lead to erratic or even violent behavior if someone perceived as a stranger suddenly approaches without warning. Set a calendar and clock in the confused person’s home so that they can check the date and time as often as they need to. If this is the very first time someone has become confused and this confusion was brought on seemingly out of nowhere, call emergency services. Abrupt confusion is a serious symptom that requires immediate medical attention.
Let confused people explore and move around unless they’re in danger. So long as there are no cliff edges or fire pits around, don’t worry if the confused person wants to poke around or inspect things. Elderly folks and people who suffer with chronic confusion often need to explore their environment to avoid anxiety and remind themselves where they are. If you are worried about them hurting themselves, go with them! Reminding the individual where they are at the moment. This can go a long way towards helping them maintain a solid understanding.
Use familiar objects to remind confused people of key information. Show them old photographs, ask them about relics on their shelves, and use things they care about to keep them focused. Sometimes having even small reminders can help a confused person recall who they are and where they are. Other times people become confused about what time, day, or year it is. Rely on visual cues when you’re communicating instructions with a confused person. Keeping a whiteboard around can really help!
Develop a routine to avoid overwhelming a confused person. Help the confused person build a routine to make things easier for them. With a stable routine, they’ll have an easier time making connections and recognizing patterns. It sounds simple, but just having a regular day-to-day routine reduces the impacts of confusion and memory loss over time. For instance, make sure they get up and go to bed at the same time each day, which can help improve their sleep and overall health.
Maintain a calm and relaxing environment. Some people who experience confusion also experience subsequent fear or anxiety. One way to help combat this is to keep the individual's immediate environment quiet, calm, and relaxing. If possible, remove things that might be traumatic or upsetting from the individual's immediate area. Be aware of sundowning. At the end of the day people with dementia can become more confused and depressed. Talk with the person's doctor if you think they are suffering from sundowning. They may have suggestions for medication or therapy that can help. Try keeping windows open during the day. This may keep the patient more alert, awake, and less confused.
Talk to a doctor about signs of gradually increasing confusion. If someone you know is slowly becoming more and more confused, it may be a sign of a deeper underlying problem. Watch out for issues related to difficulty remembering things, forgetting where they are, or losing track of concrete thoughts. See a doctor to investigate this, since there may be a number of things going on. Parkinson’s disease Alzheimer’s disease Schizophrenia Cancer Dementia
Dealing with Momentary Confusion
Take a long, deep breath to calm down and reset. Stress and anxiety are triggers for confusion, and they can exacerbate the problem if you feel confusion coming on already. If you’re sweating over an upcoming job interview or cramming for an important exam and your mind starts churning, take a long, deep breath through the nose and breathe out slowly through your mouth. Pause for a moment and relax before you get back to what you’re doing. If you’ve been struggling with anxiety (or depression), seek help. A therapist or psychiatrist will be able to help your emotional headspace in the long run.
Drink a big, tall glass of water to prevent dehydration. Dehydration is a common cause of confusion, but it’s easily preventable. Every 30 to 60 minutes or so, drink some water. Not only will this keep you hydrated, but the cold water can refresh you and stimulate your senses. This should also bring you back into the focus zone. If you want something with a little more flavor than water, squirt some citrus into the water. If you suspect you’re severely dehydrated (indicated by a high heart rate, flushed skin, chills, and/or dark urine), see a doctor. Extreme dehydration requires immediate medical attention.
Eat a healthy snack to keep your blood sugar stable. Some people experience confusion caused by low blood sugar (diabetes medications are a common cause of this). If you have an issue with your blood sugar dropping, have a small, sweet snack or beverage. Controlling your blood sugar might even out your mood and help you stay focused. Juice is an excellent option if you’ve got low blood pressure. Small snacks, including a cookie or some pretzels, can also help. Your doctor may tell you to take glucose tablets if you have a chronic problem with low blood sugar.
Write things down to recall key info and improve your memory. Try writing down appointments, errands, chores, and things you'll need to pick up when you're at the store. Make a habit of carrying that list with you everywhere you go and checking it on a daily basis. Not only will this keep you on track in your daily life, but the act of writing will actually help you retain information better! Try keeping these lists on your smartphone for a convenient way to check them. Journaling may be a good way to keep your thoughts organized and keep track of your day-to-day life and obligations.
Seek medical help if your confusion is sudden. If confusion occurs without any previous history of this symptom, call a doctor immediately. Your doctor will do a physical exam and may order blood/urine tests, neuropsychological tests, an electroencephalogram (EEG), and/or a CT scan of your head. In some cases, you may need to go to the emergency room. Call an emergency responder if you experience confusion and any of the following symptoms: Cold or clammy skin Dizziness or feeling faint Rapid pulse Fever Headache Irregular breathing (slow or rapid) Uncontrollable shivering Diabetic complications A head injury Loss of consciousness
Reducing Your Risk Factors for Confusion
Get at least 7-9 hours of rest every night. Sleep plays a massive role in your cognitive ability, as sleep helps strengthen and solidify memories in your brain. Being sleep-deprived may also lead to feelings of confusion and uncertainty. On top of that, regular rest will keep your body stable and healthy for the long run. If you want to prevent confusion as you get older, get plenty of sleep. Practice good sleep hygiene. Create a pre-bedtime routine (such as taking a shower, listening to soothing music, etc.) and stick to a sleep schedule by going to bed and waking up at the same time every day.
Follow a healthy diet to prevent confusion due to nutrient deficiencies. Dietary improvements can often help or prevent confusion. It's important to eat fresh fruits, vegetables, whole grains, and lean, low-fat protein sources like fish, skinless poultry, or tofu. Eat a diverse diet and avoid processed foods whenever possible if you want to stay alert, mentally clear, and unconfused. Following the Mediterranean diet is a good option if you’re looking for a healthy, diverse diet that is proven to keep your mind healthy and clear in the long run.
Limit your alcohol intake and don’t do drugs. Long-term alcohol abuse (or even just regular heavy drinking) can lead to cognitive impairment over time. Alcohol is toxic to the central nervous system, which can lead to a variety of confusion-inducing disorders over time. Aim to drink no more than 2 drinks a day for men, or 1 drink a day for women. Any kind of drug use can have a negative impact on your long-term memory and cognition, so don’t do drugs if you want to stay in good mental shape. Smoking may also impair your ability to avoid confusion as you get older, so cut the tobacco use if you’re a user.
Stay active to improve blood flow to the brain. Physical exercise helps increase blood flow to the brain, which may help keep your cognitive abilities at their best. If you are physically capable, try to meet the CDC’s recommendation and get 150 minutes of moderate aerobic exercise each week or 75 minutes of vigorous aerobic exercise each week. Include 2 to 3 days of strength training each week for a total of at least 40 minutes. Moderate aerobic exercise might involve walking briskly, while vigorous exercise might involve running or bicycling. Practicing yoga is a phenomenal way to work out and stay active while engaging in mindfulness, which may have additional benefits for your long-term focus!
Maintain a stable, healthy blood pressure. High blood pressure, when left untreated, can cause significant problems with your cognitive abilities. On the other end of the spectrum, low blood pressure can also cause trouble concentrating and confusion. Keep your blood pressure stable by losing excess weight, exercising regularly, eating a healthy diet, and reducing stress in your life. Talk to your doctor about your blood pressure if you’re unsure about whether your blood pressure is healthy or not given your age and activity level. If you've been prescribed medication for your blood pressure, take that medicine as your doctor instructed you.
Exercise your mind to keep it active and focused. Crosswords, sudoku, chess, and puzzles can all keep your brain sharp. If you don't use your cognitive abilities and practice them routinely, you will eventually lose those abilities. Learn something new, like a language, a musical instrument, or even a new skill set. If you don’t want to pick up something new, alter your daily routine in simpler ways to strengthen your cognitive abilities. For example, you could try playing Wordle, reading parts of the newspaper you normally don't read, or taking an alternate route you wouldn't normally take while driving. Other ways to use your cognitive abilities include reading, joining a book club (which incorporates social interaction), playing strategy games or taking classes to learn something new.
Interact with a variety of different people and maintain friends. A great way to ward off confusion is to spend time with other people. Being around others encourages you to recall past events and process current events to carry on a conversation, which is a great way to stay mentally sharp while also enjoying other people's company. If you’re alone for long periods of time, you may increase your risk of depression, stress, and anxiety, and these symptoms can contribute to confusion and memory loss over time.
Use mnemonic devices to strengthen the connections in your brain. Mnemonic devices can be used to help you remember lists, orders of operation, and musical scales. You can also make your own mnemonic devices to help you remember anything from your daily life. Try writing out the steps of something you need to do, then take the first letter of each word and try to put it in a related word or phrase. For example, the musical notes on a treble clef staff are E, G, B, D, and F. You can easily remember that with the sentence, "Every Good Boy Does Fine." Creating and using mnemonic devices helps you strengthen both your thinking abilities and your memory. Finding ways to remember the steps of a certain process may also help free up your memory to process and retain new information.
Re-engage your senses to stimulate your mental perspective. When you try an unfamiliar dish at a restaurant, notice the smell before and after you taste the food. Challenge yourself to identify certain ingredients, or practice your cognitive abilities by reading a newspaper or book while you savor the smells and tastes of an unfamiliar dish. You might also burn incense while you do your math homework, or take a walk while you listen to music. Using more than one sense when you learn or experience something new helps keep multiple parts of your brain active and may help retain memories and learning abilities.
Organize and clean your home to stay efficient and happy. Tidying up your home, especially by reducing clutter, can help to make it easier to find things and accomplish tasks. Go through old papers, notes, and to-do lists and throw them away if you no longer need them. Rearrange your furniture and belongings so that your home is as efficient and functional as possible. Ask friends or family members to help you tidy up if you are overwhelmed by the process. This should also reduce stress. Since stress has a huge impact on your mental state, a clean home should help on this axis as well.
Communicating Clearly
Speak slowly and maintain eye contact. If you speak quickly, your audience may lose track of what you’re saying. Enunciate your words carefully and pause between sentences. Also, look who you’re talking to in the eye. Not only will this help you connect with them, but looking at who you’re talking to will help you look for signs of confusion or a lack of listening. Your body language in general can help people understand you a bit better. Emphasize key information with hand movements and move slightly as you speak to maintain an interesting posture.
Reiterate yourself regularly to avoid basic misunderstanding. Don’t be afraid of repeating yourself. Reword or rephrase key information when you’re sharing it so that anybody who might be confused fully understands what’s going on. If you’re teaching children, mentoring someone, or giving instructions to employees, feel free to ask people to repeat what you just said in their own words. This is a good way to ensure that everyone is one the same page.
Encourage others to ask questions if they have them. People become confused sometimes and they don’t say anything because they’re scared to admit they don’t understand. Remind people that you’re more than happy to answer their questions, and praise folks who do step up and admit they aren’t following. Remind your class, employees, patients, or peers, “Hey, I’m always happy to answer questions if I say something confusing.”
Ask for confirmation from your audience. When in doubt, straight up ask if someone understands. There’s nothing wrong with confirming that a key piece of information is understood. This way, nobody can blame you if they claim they never knew what you meant! Just say something like, “Give me a thumbs up if you 100% understand what I’m saying,” or, “Please email me back to confirm that you’ve read and understood these instructions.”
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