Causes Of Unresponsiveness In Elderly People

unresponsive elderly person on the floor

As we grow older, a lot of things can go wrong with our bodies. One of the health issues that elderly people may suffer from is unresponsiveness.

Medically speaking, unresponsiveness is a state in which a person is at least unconscious. There are many more details to talk about regarding this condition, and in today’s guide, we’re taking a closer look at the causes of unresponsiveness in elderly people.

We’re also explaining what you can do if you come across an unresponsive senior. So keep reading if you’re looking to understand more about unresponsiveness in elderly patients and how you can help them. 

Causes of Unresponsiveness in Elderly People

Sepsis in the Elderly

Sepsis is the overwhelming -and often life-threatening- response of the body to infection. It can result in tissue damage, organ failure, and death.

In other words, when you’re suffering from an infection, your body can overreact and respond in a destructive way to that infection.

Sepsis is classified as a medical emergency, like heart attacks or strokes, that demands rapid intervention as it can lead to severe sepsis and septic shock.

Infections that can cause sepsis aren’t restricted to a particular body part. They can occur anywhere and include the following examples: influenza, pneumonia, urinary tract infections (UTIs), and recently, COVID-19. 

Some people refer to sepsis as “blood poisoning,” but that’s an inaccurate description of the condition. Globally, one-third of patients who suffer from sepsis die.

A large percentage of those who do survive end up with one or multiple life-changing side effects such as chronic pain, chronic fatigue, post-traumatic stress disorder (PTSD), organ dysfunction (organs aren’t functioning properly), and amputations.

Sepsis can render patients unresponsive as their nervous system starts to shut down if the primary stage of the condition remains untreated.

What’s the Incidence of Sepsis in Elderly 

Sepsis doesn’t just affect elderly people; it can and does occur in patients of all ages. Individuals who are very young, have a compromised immune system, or already suffer from a chronic health issue are at a greater risk of developing the condition.

That said, aging people who are older than 65 years -especially those who are dealing with health problems- are far more prone to developing sepsis compared to any other group.

Individuals who are 65 years old and up are 13 times more likely to require hospitalization with sepsis than individuals younger than 65 years.

Additionally, 63 percent of patients aged 60 years and older who are admitted to the ICU suffer from sepsis upon arrival to the hospital.

Sepsis is classified as a medical emergency, like heart attacks or strokes, that demands rapid intervention and treatment.

Why are the Elderly More Susceptible to Sepsis?

There are multiple reasons why the elderly are more at risk of developing sepsis, which can lead to unresponsiveness.

As our bodies go through the aging process, the immune system starts to lose its efficacy when it comes to fighting infections.

This makes older people more prone to contracting more infections with more severe effects. Since there’s a chance of developing sepsis with every infection we get, the risk is much greater as we grow older. 

What’s more, people are likely to develop chronic diseases as they age. For example, diabetes, kidney disease, chronic obstructive pulmonary disease (COPD), or heart failure.

It’s quite common to encounter older individuals with at least one or two chronic illnesses.

Sepsis can result from any type of infection, but the most prevalent sepsis-triggering infections among elderly people are ones affecting the respiratory system (such as pneumonia) or the genitourinary systems (such as UTIs).

Ever since 2020, COVID-19 has become another evident risk factor for developing sepsis among older patients.

Additionally, infections can result from “minor” mouth infections due to abscesses, as well as skin sores caused by a simple cut when the skin is maybe too dry or fragile, or a more severe ulcer from lying in bed or sitting in a wheelchair.

Another factor that puts elderly people at a higher risk of contracting sepsis is the difficulty of spotting infections among aging individuals. Let’s take a urinary tract infection, for example. Its symptoms commonly include:

  • A frequent need to urinate
  • A sense of urgency, as if you need to urinate immediately
  • Not feeling relieved after urinating, as if your bladder isn’t completely empty
  • A burning sensation or pain during urination
  • Foul-smelling and/or cloudy urine

However, the first sign of a UTI for many seniors is an alteration of mental status, primarily confusion or disorientation.

This means that the infection could already exist for some time before it gets noticed and diagnosed.

This can also be the situation with other infections such as pneumonia.

As infections may not be obvious in elderly people, a sign of infection in a senior could be if they become confused, demonstrate unusual behavior, or showcase worsening of pre-existing confusion or disorientation.

Symptoms of Sepsis

Regardless of age, signs of sepsis are pretty much the same among adults, which include:

  • A change in body temperature — either developing a fever with a temperature above 101.3 degrees Fahrenheit or becoming hypothermic with a temperature below 95 degrees Fahrenheit.
  • Unexplained tachycardia — rapid heart rate over 92 bpm (beats per minute).
  • Unexplained tachypnea — rapid breathing over 20 BPM (breaths per minute).
  • Shaking
  • Confusion
  • A drop in blood pressure, less than 100 mmHg systolic (a sign of septic shock).

Sepsis can quickly develop into severe sepsis and septic shock, so it’s vital to get medical help as fast as possible. 

Unresponsive Wakefulness Syndrome

Also known as a vegetative state or a persistent vegetative state, unresponsive wakefulness syndrome is a state characterized by the patient:

  • Having multiple qualities of consciousness, such as eye movement and eye blinking.
  • Having no apparent reaction to the outside world or external stimuli
  • Demonstrating no engagement or understanding of their surroundings

That said, in unresponsive wakefulness syndrome, the patient still retains a certain level of normal bodily regulatory functions such as breathing, sleep cycles, control of internal body temperature, and digestion.

The degree of their efficacy varies from one case to another.

The reason for this is that the areas housing the centers responsible for these functions are usually intact and working. 

As such, a patient suffering from unresponsive wakefulness syndrome can breathe independently of machines, open their eyes spontaneously, stay awake for intermittent periods, as well as look around, although for no apparent purpose.

Keep in mind that patients diagnosed with unresponsive wakefulness are different from those under a coma. In the latter, the patient isn’t awake.

Duration of Unresponsive Wakefulness

The period that a patient can stay unresponsive depends on the medical circumstances that put them in that state. It can be transient, continue for up to a year, or last permanently.

Recovery from Unresponsive Wakefulness

Nowadays, it’s generally accepted that there’s a chance for patients to regain consciousness during the second year after sustaining their injuries.

However, there’s no way to know how their brain/body functions and quality of life will turn out.

What’s more, there isn’t a set of standards for the diagnosis of unresponsive wakefulness. Around 40 percent of cases are clinically misdiagnosed.

Metabolic Causes

Sudden unresponsiveness in elderly people with the absence of other abnormal vital signs could be the result of metabolic issues such as:

  • Hypercarbia 
  • Dysglycemia
  • Electrolyte disorders
  • Thyroid disorders
  • Uremic or hepatic encephalopathy
  • Hyperammonemia
  • Wernicke encephalopathy

What to Do if an Elderly Person is Unresponsive

If someone isn’t moving and doesn’t react when you call their name, talk to them, touch them, or gently shake their bodies, they’re unresponsive.

If you’re in a situation where an elderly individual is unresponsive, follow the measures below:

If the Person is Unresponsive and Breathing

1. Check the person’s breathing by tipping their head back, then looking at their chest and feeling for breaths with your cheek or hand.

When an individual is unresponsive, their muscles will relax, including the tongue. This can cause the tongue to block their airway, preventing them from breathing.

Tilt the person’s head back and pull their tongue forward to open up their airway. If they’re breathing, you should notice their chest moving and feel the breaths on your cheek or hear their breath.

If the person is breathing, continue to step two.

2. Position the unresponsive individual onto their side while tilting their head back. Moving the person like that helps clear their airway and keep it open.

Also known as the recovery position, this layout ensures that the person’s tongue is falling forward while any blood or vomit drains out.

3. Call 911 as soon as you can. If you’re not able to do it, get someone else to make the call.

If the Person is Unresponsive and Not Breathing

1. Check the person’s breathing by tipping their head back, then looking at their chest and feeling for breaths with your cheek or hand.

When an individual is unresponsive, their muscles will relax, including the tongue. This can cause the tongue to block their airway, preventing them from breathing.

Tilt the person’s head back and pull their tongue forward to open up their airway. If they’re breathing, you should notice their chest moving and feel the breaths on your cheek or hear their breath.

If the person isn’t breathing, continue to step two.

2. Call 911 as soon as you can. If you’re not able to do it, get someone else to make the call.

3. Perform chest compressions on the unresponsive person via the following steps:

  • Place your palms on the middle of their chest
  • Push firmly downwards
  • Release the pressure
  • Continue to push in and release at a constant rate until help arrives

The purpose of chest compressions is to keep blood circulating around the body to help maintain the function and integrity of the vital organs such as the brain and heart.

Frequently Asked Questions (FAQs)

Is unconscious and unresponsive the same?

From a medical point of view, when you call an individual unresponsive, it refers to them being at least unconscious and possibly dying or dead. Unconsciousness is classified as an unresponsive state. An unconscious person may look like they’re sleeping, but they may not respond to external triggers such as being touched, getting shaken, or loud noises. A type of unconsciousness is fainting, which happens suddenly and mostly lasts for just a few seconds.

Should I try talking to someone who is unresponsive and breathing?

Yes. If you find someone unresponsive but breathing, you should talk to them and try to give reassurance. Even if the person doesn’t respond to your attempts to speak to them, there’s a chance they’re still able to hear what’s happening.

How long can someone be unresponsive for?

The period that a patient can stay unresponsive depends on the medical issue that led to the state, which can be transient, continue for up to a year, or last permanently.

Can dementia cause unresponsiveness?

● Loss of ability — dementia can affect different areas of the brain involved in an individual’s ability to plan and perform a task. In particular, if the frontal lobe of the brain gets damaged, it can deprive you of the “spark” that helps you decide what to do, initiate the activity, and see it through. As the person suffering from dementia realizes they’re losing such an ability, it can lower their confidence and self-esteem, which can then cause them to withdraw and become more unresponsive with time.
● Dealing with overwhelming emotions — coping with a diagnosis of dementia can bring about a range of difficult emotions depending on the person, ranging from fear to sadness, to anger, to embarrassment.
The patient may prefer to retreat from others while trying to cope with these complex emotions, becoming unresponsive in the process. Additionally, dementia can also cause depression, which is another reason for becoming unresponsive.

Wrapping it Up

There you have it, a complete guide on the causes of unresponsiveness in elderly people. Remember, if you find yourself in a situation where you have to deal with an unresponsive senior, call 911 right after you check their breathing.