Long-Term Care Survey Alert

Published on Fri Sep 24, 2004 PDF

Beware these common causes of mental status and behavior changes.

Problem: Nursing and medical staff can miss the window for treating a resident's acute medical condition if they chalk up a resident's change in behavior or mental status to his pre-existing dementia, cautions Charles Crecelius, MD, PhD, a nursing home medical director and geriatrician in St. Louis, MO.

Solution: "Staff has to be familiar enough with a resident's baseline characteristics to be able to tell if a relative change in his behavior or function ... signals a medical illness, medication or serious psychosocial stressor," says Crecelius. "While staff often notice hyperactive delirium relatively quickly, they may miss hypoactive delirium for some time, attributing it to sleep, fatigue or a hectic day," he tells Eli.