Dealing with Confusion and Disorientation During the Dying Process
For many patients as well as families, confusion, disorientation, and loss of control are some of their greatest fears. At times, the patient may be confused about the time, place and identity of people surrounding him/her, including family members and close and familiar people.
Disorientation can increase as the patient becomes imminent. Care should be taken to accurately assess if the patient is truly confused/disoriented or experiencing a “nearing death awareness.” Confusion can be difficult to cope with in any setting, and the caregiver can quickly become fatigued. While safety measures such as 24 hour supervision should be instituted, it is also vital that the patient and family receive increased psychosocial support and reassurance in an effort to calm these fears. Increasing caregiver and/or volunteer support can be a great relief to the caregiver and patient.
To provide more effective communication with confused and disoriented patients, hospice caregivers and family members should identify who they are upon entering the room and speak clearly and truthfully when something important needs to be communicated to the patient. An accurate assessment of the source of confusion is important, as confusion can be a consequence of pain, medications, full bladder, fecal impaction, and other disease processes.
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