# Podcast 1002: Elder Agitation

Page: https://stenobird.com/podcast/emergency-medical-minute-972156/podcast-1002-elder-agitation
Text version: https://stenobird.com/podcast/emergency-medical-minute-972156/podcast-1002-elder-agitation.md
Podcast: [Emergency Medical Minute](https://stenobird.com/podcast/emergency-medical-minute-972156)
Published: 2026-04-20T09:00:00+00:00
Episode link: https://emergencymedicalminute.libsyn.com/podcast-1002-elder-agitation
Audio file: https://traffic.libsyn.com/secure/emergencymedicalminute/Elder_Agitation_Lessen.m4a?dest-id=465437
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JSON: https://stenobird.com/v1/public/podcasts/emergency-medical-minute-972156/episodes/podcast-1002-elder-agitation
Duration seconds: 215

## Resource

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 possible: Diphenhydramine and other anticholinergics, which can worsen delirium (including urinary retention and sedation) Benzodiazepines, which may worsen confusion, falls, and respiratory depression Haloperidol, which has a higher risk of extrapyramidal symptoms and QT prolongation than many atypicals References Badwal K, Kiliaki SA, Dugani SB, Pagali SR. Psychosis Management in Lewy Body Dementia: A Comprehensive Clinical Approach. J Geriatr Psychiatry Neurol. 2022 May;35(3):255-261. doi: 10.1177/0891988720988916. Epub 2021 Jan 19. PMID: 33461372. Kurlan R, Cummings J, Raman R, Thal L; Alzheim…

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