What to do if you find a confused elderly person?

Sudden confusion, or delirium, in older adults is a medical emergency that can be caused by infection or other serious conditions. If you find a confused elderly person, knowing the correct protocol is essential for their safety and getting them the immediate medical attention they may need.

Quick Summary

To assist a confused senior, first ensure their immediate safety by assessing the surroundings, then approach them calmly to provide reassurance. Stay with the person, make an emergency call if needed, and offer simple communication to help de-escalate their distress while waiting for help to arrive.

Key Points

• Prioritize Safety: First, move the person away from immediate hazards like traffic or extreme weather to a safer, calmer area.

• Approach Calmly: Use a gentle, reassuring tone and relaxed body language. Make eye contact and get down to their level to be less intimidating.

• Communicate Simply: Ask one simple, closed-ended question at a time. Avoid quizzing them or arguing with their perception of reality.

• Call for Help: For sudden confusion, call 911 immediately and provide a clear, concise report. Use non-emergency numbers for less urgent situations.

• Distract and Reassure: While waiting, offer simple comforts like a blanket or a drink. Acknowledge their feelings and remind them that they are safe.

• Identify the Cause: Understand that sudden confusion (delirium) requires immediate medical attention and is different from the gradual decline of dementia.

Your First Priority: Ensuring Immediate Safety

When you first encounter a confused elderly person, it is vital to prioritize their immediate safety. Assess the situation for any potential hazards. Are they near a busy road, in extreme weather, or in a place that poses a risk? Guide them gently away from danger, moving to a quieter, safer spot if possible. Your calm demeanor is your most important tool in this moment. A panicked response from you can increase their anxiety and agitation.

Assessing the Situation

First, take a moment to observe. Is the person wandering aimlessly, or do they appear focused on a task? Are they dressed appropriately for the weather? Note their emotional state—are they frightened, angry, or distressed? These observations will be crucial information for emergency responders later on. Look for any visible medical alert bracelets, identification, or other belongings that might offer clues about their identity or health conditions.

How to Approach and Communicate Effectively

Approaching a confused individual requires a gentle, non-threatening manner. Your communication style can make all the difference in keeping them calm and building trust.

Dos of Communication

• Get on their level: Physically get down to their eye level, especially if they are seated. This is less intimidating than standing over them.
• Use a calm, slow tone: Speak slowly and clearly, without raising your voice. A reassuring tone is more important than the exact words you use.
• Introduce yourself simply: "Hello, my name is [Your Name]. I am here to help you." Be direct and friendly.
• Use simple, single questions: Ask one question at a time and use yes/no formats. "Are you thirsty?" is better than "What can I get you to drink?".
• Listen patiently: Give them plenty of time to respond, and listen with your "ears, eyes, and heart" to understand the feelings behind their words.
• Validate their feelings: If they express fear or distress, acknowledge it. "I understand this is scary, but you are safe with me." Never argue with their reality, as this can increase confusion and agitation.

Don'ts of Communication

• Don't crowd their personal space: Maintain a respectful distance that doesn't feel threatening.
• Don't ask memory-testing questions: Avoid asking things like, "Do you know where you are?" or "What's my name?" This can cause embarrassment and distress.
• Don't take their words personally: Their confusion is caused by an underlying issue, not a personal slight. Stay calm and compassionate.

Making the Right Call: Contacting Emergency Services

When to call for help depends on the situation. For immediate, life-threatening danger, call 911. For a non-emergency, consider a local non-emergency line or Adult Protective Services (APS).

When to call 911

Call 911 immediately if you observe any of the following:

• The person is disoriented, delirious, or has experienced a sudden change in mental state.
• They appear to be injured or are in physical distress.
• They are in immediate danger and cannot be moved to safety.
• You cannot determine who they are or find emergency contact information.
• They are a potential danger to themselves or others due to agitation.

What to tell the dispatcher

When you call, be prepared to provide the following information concisely:

1. Your location: Be specific about where you are and the best way for responders to reach you.
2. The person's location: Describe where the individual is, including any notable landmarks.
3. The situation: Explain that you have found a confused elderly person and describe their behavior.
4. Any physical signs: Report any injuries, visible distress, or unusual symptoms you have noticed.

Distraction and Reassurance While You Wait

While waiting for emergency services, your continued presence is reassuring. Keeping them engaged in a simple, calming activity can help.

• Offer a simple task: Give them a light task to focus on, such as holding a soft blanket or a familiar object, if they will accept it.
• Use distraction: Point out something in the environment that isn't threatening, like a bird or a flower. This can redirect their attention from their confusion.
• Offer a drink or snack: If they are calm and able, offer a small snack or a drink of water, as dehydration is a common cause of confusion.

Delirium vs. Dementia: Understanding the Difference

It's helpful to understand that while a person with dementia can become confused, a sudden onset of confusion is a hallmark of delirium, which requires urgent medical assessment.

Feature	Delirium	Dementia
Onset	Acute, rapid onset (hours to days).	Gradual, slow onset (months to years).
Course	Symptoms fluctuate wildly throughout the day.	Symptoms are relatively stable over a day but worsen over time.
Attention	Impaired, easily distracted, trouble focusing.	Generally alert in the early stages.
Causes	Medical conditions like infection, dehydration, medication side effects.	Neurodegenerative diseases like Alzheimer's.
Reversibility	Often reversible with proper medical treatment.	Generally irreversible and progressive.

Conclusion

Finding a confused elderly person can be alarming, but acting with a calm, compassionate approach is the most effective response. Ensuring their safety, communicating clearly and gently, and promptly contacting the appropriate authorities are the most critical steps. Your quick, thoughtful actions can make a profound difference in a vulnerable person's life and ensure they receive the medical help they desperately need. For more authoritative resources and information, visit the National Institute on Aging website.

Frequently Asked Questions

What are the first things I should do if I find a confused elderly person?

Your first steps should be to ensure their immediate safety by moving them away from any dangers. Then, approach them calmly, introduce yourself gently, and ask if you can help. Look for any form of identification or medical information they might have.

Should I call 911 if the confused elderly person isn't in immediate danger?

If their confusion is sudden, it could be a sign of a medical emergency like an infection or stroke, which warrants a 911 call. If you are unsure, it is always safer to call 911 and explain the situation to the dispatcher. They can help determine the appropriate next steps.

How should I speak to a confused senior to avoid making them more agitated?

Speak in a calm, soothing voice using short, simple sentences. Avoid asking complex questions or quizzing them on their memory. Maintain a respectful distance and use gentle body language to make them feel safe and reassured.

What if the confused elderly person insists they need to go 'home' when they are already there?

It is often counterproductive to argue. Try to meet them in their reality and gently redirect them. For example, you could say, 'That's a great idea, but let's have a snack first,' and engage them in another simple activity. The desire to 'go home' can sometimes mean they are seeking a feeling of comfort and security from an earlier time in their life.

Could a urinary tract infection (UTI) really cause confusion in an elderly person?

Yes, a urinary tract infection is a common cause of delirium and sudden confusion in older adults. It is one of the many medical issues that require prompt diagnosis and treatment to resolve the confusion.

What information should I have ready when I contact emergency services?

Be prepared to provide your precise location and a clear description of the person and their state of confusion. Mention any possible medical information you may have found, like identification or a medical alert bracelet.

Should I try to provide them with food or water?

You can offer a small sip of water or a light snack if the person is calm and appears able to accept it. However, if they are distressed or uncooperative, do not force them. Dehydration can cause confusion, but their immediate safety is the top priority.