
Podcast 1002: Elder Agitation
From Emergency Medical Minute by Emergency Medical Minute
April 20, 2026 · 4 min
About this episode
This episode discusses the causes and management of agitation in the elderly, including environmental changes and medication options.
Contributor: Aaron Lessen, MD Educational Pearls: What are the common causes of agitation in the elderly? Baseline dementia causing a behavioral disturbance Delirium precipitated by an acute medical problem such as a UTI, pneumonia, overdose/side effect of home medications, urinary retention, constipation, pain, hypoxia, electrolyte abnormality, etc. Exacerbation of a primary psychotic condition such as schizophrenia or bipolar disorder. What environmental changes can help reduce agitation? Maintain a quiet, calm, uncluttered environment Dim the lights Ensure the patient has their glasses, hearing aids, and dentures Avoid excessive lines such as foleys Minimize restraints and other forms of immobilization Reassure the patient frequently and have the family check in with the patient What are the best options if medications are required? If the patient is unsafe or non-pharmacologic measures fail, consider a second-generation ("atypical") antipsychotic using the lowest effective dose: Olanzapine Risperidone Quetiapine One special consideration is Dementia with Lewy Bodies, which can be very sensitive to antipsychotics. In this case, Quetiapine is the preferred agent. Avoid when…
People in this episode
Guest: Aaron Lessen, MD
Topics covered
- elder agitation
- dementia
- delirium
- psychotic conditions
- non-pharmacologic measures
- antipsychotic medications
Keywords
- elderly agitation
- dementia
- delirium
- antipsychotics
- non-pharmacologic measures
- environmental changes
- medication management
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