AMS in the older adults

Diagnosing and Managing Delirium in Older Adults


D.E.L.I.R.I.U.M. mneumonic


Electrolyte abnomalities: dehydration

Lack of drugs


Reduced sensory input

Intracranial pathology

Urinary or fecal retention

Myocard & Lungs


For pain control in geriatric patients morphine (MSI) 2 mg IV and re-assess.

At all cost steer away from physical restraint. If you have to use Haloperidol 0.5-1.0 mg IV or IM or orally. No Benzodiazepines (unless alcohol withdrawal or Benzo withdrawal)

Alternative: Olanzapin in low doses (2.5 mg).


Preventing delirium:

(1) treat pain, (2) hydrate, (3) give food if possible, (4) continue regular medication, (5) put in appropriate environement, (6) do not forget hearing aids etc, (7) involve relatives

DELIRIUM in the Elderly MNEUMONIC.jpg