Impaired thinking and changes in awareness can affect people with advanced cancer in varying degrees. These symptoms known as confusion and delirium, may range from occasional forgetfulness to, in extreme cases, dramatic changes in personality and a loss of any sense of reality.

Confusion can come on suddenly or gradually, it can come and go or be more permanent. and can have an impact on your activity level and alertness.

The type of cancer itself (eg. a brain tumour) may cause the confusion. It can be caused by medications, dehydration, changes in the body’s chemical balance, infection or reduced amounts of oxygen getting to the brain.

While confusion and delirium is common in the final days of life, it is particularly distressing when your faculties are otherwise in order and you are aware of your feeling of confusion.

What may help

Talk to your Doctor

Whatever is causing the confusion, it may be treatable. Some medications may be available to help you.

Get organised

If you are worried that forgetfulness or other lapses in awareness may affect your everyday duties, you may need to swallow your pride and consider delegating the more important responsibilities, keeping thorough diary entries for example about what you normally do in a day or what needs to be done, writing notes to yourself (that others may take a cue from if need be) or asking trusted friends to follow up with you.

Tips

If you are worried you may be caught out by confusion in public, wear a medical bracelet that carries your details and the nature of your condition.

For more information

Palliative Care Victoria has a brochure about confusion and terminal restlessness or phone (03) 9662 9644.

Life, Hope & Reality was developed and written by Afaf Girgis, Claire Johnson, and Sylvie Lambert with funding from the NHMRC and Cancer Council NSW.

Last updated 30 August 2015