Recognizing Seizures and First Aid
Handling any type of seizure involves one simple principle: to protect the person from harm until full awareness returns.
Handling Convulsions in an Older Person
- Ease the person having the seizure into a reclining position on the floor or flat surface.
- Put something soft and flat under the head.
- Turn him or her gently on to one side to prevent choking and keep the airway clear.
- If the person having the seizure is seated, turn gently to one side so any fluids drain away from the mouth.
- Don't try to force anything into the mouth. Seizures do not cause people to swallow their tongues.
- Don't try to give fluids or medicine until the seizure is completely over and the person is fully alert again.
- Don't try to restrain the jerking movements. Muscles contract with force during seizures. Applying restraint could cause tears in the muscle or even break a bone, especially in elderly people whose bones may be fragile.
Responding to Confusion in an Older Person
Confusion may occur during a complex partial seizure or during the recovery period after other types of seizures.
In either case, the same basic rules apply:
- Remove anything from the area that might cause injury or could be a hazard to someone who is temporarily unaware of where he is or what he's doing.
- Don't try to restrain an older person who is wandering and confused during a complex partial seizure. If danger threatens, guide gently away.
- People may be quite agitated during these episodes. Trying to restrain them, or grabbing hold, is likely to make the agitation worse and may trigger an aggressive response.
- Be reassuring, comforting and calm as awareness returns. If confusion persists, get a medical evaluation.
Most seizures, even in elderly people with other health problems, end naturally without any special treatment. Although emergency medical assistance should be obtained when someone has a first seizure, subsequent seizures usually do not require special treatment.
However, it is always possible for more serious problems to develop. Here are a few ways to spot them:
- Watch the time. If the convulsive shaking and jerking of a tonic clonic seizure lasts longer than five minutes, or starts up again shortly afterwards, call an ambulance or follow specific instructions from the doctor on in-home care. Non-stop seizures, which doctors call status epilepticus, are quite dangerous for elderly people. Prompt medical care is needed.
- Check for secondary injuries. Seniors who have seizures may break bones, so special care should be taken to find out if there's any unusual pain following a seizure. Headaches are quite common, but a severe headache after a seizure in someone who doesn't usually have them should be checked out.
- Call for help if breathing is labored following the seizure, if there is chest pain, or unusual pain of any kind, or if consciousness does not return after a few minutes.
- Be aware that periods of confusion lasting more than one hour associated with seizures may signal that something is seriously wrong.
If an older person with a seizure disorder who does not have a mental impairment seems to slip in and out of a confused or agitated state with few intervals of normal awareness, you may be seeing another kind of continuous seizure activity. This, too, should be evaluated at a hospital.
If you are living with an older person with seizures who has other medical problems, check with the doctor about how he or she wants you to respond when a seizure happens.
Find out whether the doctor wants to be notified every time or just in certain circumstances.
Ask whether or when you should call an ambulance; and if there are any special warning signals that you should be on the lookout for.