Age-Friendly Approaches to Managing Mentation, A Delirium Case Review

Area of Science:

• Geriatrics
• Internal Medicine
• Neurology

Background:

• Delirium is prevalent in older adults within post-acute care settings.
• Hypoactive or mixed delirium presentations are frequently missed.
• Older adults are susceptible to delirium following orthopedic surgery, such as hip fracture repair.

Purpose of the Study:

• To illustrate the effective management of delirium in an older adult using the Age-Friendly 4Ms framework.
• To emphasize the importance of early recognition and interdisciplinary collaboration in addressing delirium.
• To highlight the role of the 4Ms framework in optimizing recovery and functional return.

Main Methods:

• A case study approach detailing an 85-year-old male patient admitted to rehabilitation post-hip fracture repair.
• Application of the Age-Friendly 4Ms (What Matters, Medication, Mentation, Mobility) framework by an interdisciplinary team.
• Implementation of evidence-based pharmacologic and nonpharmacologic interventions.

Main Results:

• The patient presented with acute confusion, inattention, fluctuating consciousness, and functional decline.
• Interdisciplinary interventions guided by the 4Ms framework led to substantial patient improvement within one week.
• The case demonstrates successful management of delirium in a post-acute care setting.

Conclusions:

• Early recognition of delirium, particularly hypoactive or mixed types, is critical for timely intervention.
• Interdisciplinary collaboration is essential for comprehensive delirium management.
• The Age-Friendly 4Ms framework provides a structured approach to optimize recovery and functional outcomes in older adults with delirium.