Management

The first priority is diagnosis and treatment of the medical cause, such as occult infection, acute intoxication (e.g. opiates), withdrawal of alcohol or benzodiazepines, or adverse reaction to medication, polypharmacy being a common cause in the elderly.

These patients will often present in the general hospital, and are frequently on a medical 'take'. Probably the commonest type would be 'acute-on-chronic'; that is, a person with a - perhaps unrecognized - background of mild cognitive impairment who becomes acutely confused in association with an intercurrent medical problem such as chest infection - or even something as mild as constipation.

Nursing care, best carried out by one or two familiar people, is important. It includes attention to fluid intake and bladder and bowel function, provision of quiet, warm, well-lit surroundings without too many strange people around, protection against such hazards as unsupervised smoking in bed, and clear explanations before doing any practical procedures.

Drug treatment, preferably with an antipsychotic started at low dose and increased as necessary, may be required to reduce disturbance or distress. Halo-peridol in doses as low as 0.5 mg can be effective in the elderly; younger, fitter patients may require higher doses. Most cases are treated in general medical wards without involving psychiatrists.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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