Yes, we were often lost. But not severely. The only drastic error you might make is to cross the Incachuana Pass (4950m) rather than the Salcantay Pass.
The Incachuana Pass takes you to the Inca Trail. Some hikers do it as an add-on. Some trekking companies call that guided variation of the Inca Trail, the Salcantay. This is easily confused with our hike.
Remember this: turn left when you get to the mountains, not right. And do not try this hike without a good map & the Lonely Planet guidebook.
The Salcantay Pass trail is unsigned, often vague. Do not try this hike without a good map & the Lonely Planet guidebook. We often confirmed the best route with local people we met.
Once you reach the Santa Teresa river, you might assume it would be simple to follow it down to La Playa. Yet we still were confused at times which side of the river we needed to follow.
Leaving the town of La Playa, you must walk a rough gravel road (a bit depressing) for a while, searching for el camino a 122 (path to km 122), a spot on the train tracks en route to Aguas Calientes.
We asked many local folks on the road how to get to that path. They were stumped. The guidebook directions were confusing.
Finally we asked for el camino Llactapata (path to Llactapata) and everyone, even small children knew what we were talking about. We hired some kids to show us the scramble up the mountain side to the excellent path to Llactapata, the best trail on this Trek.
Good luck with the route finding!