Confusion, Restlessness and Agitation

As a person declines, they may become confused, restless, or have increased agitation.  Even though they are too weak, they may insist on getting out of the bed.  They may yell out and become angry toward those around them.  They may say or see things that have no meaning.  Some may accuse those trying to help of causing them harm.  They appear extremely agitated and are sometimes unaware of their current condition.  Caregivers should remember this is not who they are – this is from the disease and how it is causing changes to the body.

When this occurs, assess if the patient is comfortable.  Is he/she in pain?  If the patient is unable to verbalize their comfort level, observe facial expressions or body movements that indicate pain.  If the patient is grimacing, administer medication as instructed by the nurse.  If they have an indwelling catheter, is it working properly or is it causing pressure in the bladder?  Look to see if there is urine flowing in the tubing.  Is the patient getting enough oxygen?  Make sure the oxygen is turned on and nothing is obstructing the tubing.  Medications for anxiety can be administered to help the patient rest more comfortably.

Other things you can do include:

• Keep the patient oriented to time by keeping a calendar or clock close by
• Decrease the noise level in the room
• Talk calmly
• Explain to the patient what you are doing
• Place familiar objects close to the patient
• Promote relaxation and sleep
• Avoid asking the patient to do anything that makes him/her fearful or uncomfortable.