Counselor Toolbox Podcast with DocSnipes 1081 - 10 Tools to Understand and Address Agitation, Delirium and Sundowning
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Nov 10, 2025 Explore the spectrum of cognitive impairment, from aging to dementia, and discover common misdiagnoses. Learn about reversible causes of cognitive changes, including hydration and medication side effects. The discussion highlights multi-component interventions versus relying on medications. Delirium types are defined, revealing critical distinctions between hypoactive presentations and sundowning. Engage with strategies to manage agitation and improve hydration for older adults. Practical tips abound, including addressing grief and anxiety, to enhance care and comfort.
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Simple Home Checks For Cognitive Change
- Test hydration by skin tenting and inspect eyes, and ask about recent diarrhea or diuretic use.
- Consider hypothyroid and medication side effects as reversible cognitive causes.
Family Experience With Benzodiazepines
- Dr. Snipes described his grandfather's hypoactive delirium after being prescribed Valium, which worsened into lethargy.
- The family learned the benzodiazepine likely shouldn't have been given to an older adult.
Use PEACE And FAST Protocols
- Use the PEACE framework (physical, interpersonal, emotional, cognitive, environmental) to investigate agitation causes.
- For suspected stroke use FAST: face, arms, speech, time to call 911.