Confusion or Impaired Judgment

The mental status of a person with HIV infection may change suddenly, leading the person to exhibit symptoms ranging from confusion and forgetfulness to severe dementia and psychosis.

The person who has confusion or impaired judgment may be unable to remember where dangers lie, or to judge what is dangerous (steps, stoves, medications). Fatigue and inability to make the body do what one wants also can lead to injury. Therefore it is very important that this person live in an environment that has been made as safe as possible. The following are some safety guidelines to use in your home:

• Keep clutter out of the hallway and off stairs or anywhere the person is likely to walk. Remove small rugs that could cause tripping.
• Remove breakables and dangerous objects (matches, knives, lighters).
• Keep medications in a locked cabinet or drawer.
• Limit access to potentially dangerous areas (bathrooms, basement) by locking doors if the person tends to wander. Have the person wear an identification bracelet in case he or she wanders outside.
• Dress appropriately for the season.
• Put name labels in clothing. Make sure clothing is not too baggy and that shoes fit well and have nonskid soles.
• Keep the person's bed low. If he or she falls out, you may want to place the mattress on the floor or install side-rails.
• Make sure rooms are well lit, especially in the evening. Night-lights can help prevent falls.
• Have someone stay with the person who is severely confused or agitated or place the person in a day care centre.
• Encourage rest periods if the person tires easily.
• Keep exit doors locked. Consider some type of exit alarm, such as a bell attached to the door.
• Consider a mat alarm under a bedside rug to alert others of the person getting up during the night.

Encourage the person to do the following:

• Rest frequently. Don't let the person get fatigued.
• Avoid crowded places such as shopping mall and stadiums.
• Have someone with the person when he or goes outdoors.
• Keep meal times quiet and calm.
• Limit the number of visitors.
• Have the person do one activity at a time.
• Keep activities simple - this will minimize fatigue.
• Plan activities ahead of time.
• Ensure that medications are taken as prescribed.
• Keep a calendar of activities visible on the wall. Cross off days as they pass.
• Maintain a photo album with labeled pictures of family members, friends, home, and so on.
• Include the person in family activities and conversations.
• Remember to treat the person with respect and maintain his or her privacy.
• Discuss all medication use with the health care provider.

Some things to avoid during periods of confusion

• Alcohol
• Contact sports
• Horseback riding
• Swimming
• Hunting
• Power tools or sharp implements
• Driving
• Riding recreational vehicles such as bicycles, skateboards, motorcycles, or snowmobiles
• Cooking without supervision