As we age, our bodies and minds inevitably go through a natural process of change. A common symptom of these changes among older adults is confusion. Confusion in the elderly can manifest in many different ways and can be caused by various factors. A person might feel confused as the result of medical conditions, medications and environmental factors.

It can be a frightening and frustrating experience, not just for the person affected but also for their loved ones and caregivers. It’s important to understand what can cause confusion in older people and how to recognise the signs, so that you can help your loved ones stay independent and improve their quality of life.

In this guide, we will explore the causes of confusion in the elderly, its effects on their daily lives, and strategies to help manage it.

What can cause confusion in older people?

Medications and drug interactions

Some medications, especially those that affect the central nervous system, can potentially lead to confusion and cognitive impairment in older adults. Drug interactions can be especially problematic for older individuals and can even exacerbate symptoms.

Dehydration and malnutrition

Dehydration and malnutrition can cause confusion and disorientation in older people. Inadequate fluid intake, reduced appetite, or underlying medical conditions can all lead to older people becoming dehydrated or face issues with malnutrition.

Infections and medical conditions

Some infections can lead to confusion and delirium in older adults. Delirum can be caused by serious infections often brought on by common conditions such as urinary tract infections, respiratory infections or sepsis. Other medical conditions like stroke, dementia, and Parkinson’s disease can also lead to issues with confusion and disorientation.

Sleep disturbances

Insomnia, sleep apnea and other sleep disturbances can disrupt the sleep patterns of older adults and cause daytime confusion, fatigue, and cognitive impairment.

Environmental factors

Changes in the environment such as sensory overload or sudden changes in routine can cause confusion and disorientation in some elderly people. These factors can be particularly challenging for individuals with cognitive impairment or dementia.

What medications can cause confusion in elderly people?

Some medications can cause confusion in elderly people, which can be concerning for both the individual and their loved ones.

It’s important to be aware of the medications that may cause confusion, so that steps can be taken to prevent or manage any adverse effects:

  • Anxiety and insomnia medications, while beneficial for many people, may cause sedation and mental slowing that can lead to confusion.
  • Corticosteroids, which can be life-saving when used appropriately, have the potential to induce delirium, mood changes, and even psychotic symptoms. Pain medications, particularly opioids, can affect short-term memory, but their proper use is important for pain relief.
  • Chemotherapy drugs are well known to lead to cognitive changes. It is so common that it is often known as “chemo brain”. These medications can impact attention, memory, and problem-solving.
  • Statins are drugs used to lower cholesterol, but they have been suspected of causing mental slowing and memory problems in some people. The research in this area is divided.

How to tell if someone is confused

It can be challenging to tell if someone is confused, particularly if they are trying not to show it or are experiencing mild symptoms. There are several signs and symptoms that you can look out for that may indicate confusion in older adults. Being able to recognise these signs is crucial for carers and family members to provide appropriate support and care.

Some of the possible signs of confusion in older adults incude:

  • Difficulty concentrating or paying attention
  • Memory problems or forgetfulness
  • Disorientation or confusion about time, place, or people
  • Inability to follow instructions or carry out tasks
  • Changes in behaviour, mood, or personality
  • Agitation, restlessness, or irritability
  • Slurred speech or difficulty communicating
  • Hallucinations or delusions

Delirium vs. Confusion

Dementia and delirium are two related but distinct conditions that can affect older adults. While both can cause confusion, agitation, and other cognitive symptoms, they have different causes and symptoms.

Delirium often starts suddenly and is typically caused by an acute illness or harmful drug interactions. Dementia has a more gradual onset and is typically caused by physical changes in the brain.

Delirium is a sudden condition that affects mainly attention and awareness. It is often a symptom or side effect of another underlying condition such as infection or medication toxicity.

Delirium can happen suddenly over 1-2 days. It can be life-threatening and requires immediate medical attention. However, it is often reversible once the underlying cause is identified and treated.

Dementia, on the other hand, is a chronic condition that affects mainly memory and other cognitive functions. It is typically caused by anatomical changes in the brain and has a slower onset than delirium. Unlike delirium, dementia is a progressive condition. Although with support and the appropriate medications, symptoms can be managed and delayed.

What to do if someone you love is confused

If you or a loved one is experiencing confusion, agitation, or other cognitive symptoms, it’s important to seek medical advice as soon as possible. Delirium can be life-threatening and dementia requires proper diagnosis and management.

By seeking medical attention, you can help ensure that you or your loved one receives appropriate care and treatment. A medical evaluation can help identify the cause of your loved one’s confusion and determine the appropriate course of treatment.

If your loved one is experiencing sudden confusion, it is important to create a safe environment. Confusion can cause disorientation and make it difficult for someone to navigate their surroundings. Ensure that their environment is free from hazards and that they have access to everything they need.

Be sure to provide your loved one with comfort and emotional support. Confusion can be scary and disorienting, so try and offer reassurance and emotional support to help reduce anxiety and stress levels.

How Oxford Aunts can help

At Oxford Aunts, we have provided live-in care throughout Oxfordshire and beyond for over 50 years. Our dedicated care has enabled people to stay safely and happily at home with all the support they need.

This includes people experiencing confusion or living with dementia. Our experienced and trained carers can provide compassionate care and support for your loved one in the comfort of their own home.

We offer a range of services tailored to your loved one’s needs, including medication management, personal care, housekeeping, and companionship. Our carers are trained to recognize the signs of confusion and can provide appropriate support to help manage your loved one’s symptoms.

If you’re looking for professional care services for your loved one who is experiencing confusion, contact us to learn more about how we can help. We’re here to provide compassionate care and support for the whole family.

Get in touch with us about your care needs

Our expert care advisors are here to help you understand the options available to you. Contact us today to learn more about how live-in care can improve the quality of your life.


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