Icon for Key Principle 4

PRINCIPLE 4: Management of older people with confusion

NSW hospitals will have programs in place for older people with confusion that align with these principles. The implementation will be in partnership with the older person, their carer and family.

Management of older people with confusion

The first line management of the older person with confusion is to treat the underlying cause of confusion.

The general management of confusion is multimodal and includes addressing physical, medical, social and psychological needs. The older person (if possible), carer and clinicians should work in partnership to develop a care plan with shared goals based on the person’s values and experiences (1). This will ensure the care plan is centred around the physical, medical, social and psychological needs of the confused person.

Management should be designed to meet the older person’s specific needs and manage any identified risks (2). Strategies to manage confusion are the same as strategies to prevent confusion.

Management of dementia in older people

For older people with a confirmed diagnosis of dementia, it is important to acknowledge and integrate the diagnosis of dementia into care planning, as dementia impacts on all aspects of care, treatment and planning in hospital (3).

Dementia and delirium care with volunteers resources

There is evidence that multicomponent intervention strategies that are supported by the use of volunteers or family carers can prevent delirium.

See Dementia and delirium care with volunteer resources.


  1. NSW Ministry of Health, Royal Australian and New Zealand College of Psychiatrists. Assessment and management of people with behavioural and psychological symptoms of dementia (BPSD). A handbook of NSW clinicians. NSW Ministry of health and the Royal Australian and New Zealand College of Psychiatrists 2013.
  2. Australian Commission on Safety and Quality in Health Care. Handbook for improving safety and providing high quality care for people with cognitive impairment in acute care: A consultation paper. Sydney: 2013.
  3. Victorian State Government Department of Health. Best Care for Older People Everywhere: The Toolkit 2012. Available from: https://www.health.vic.gov.au/publications/best-care-for-older-people-everywhere-the-toolkit-2012