An 85-year-old patient is admitted through the emergency department for confusion and disorientation.The family states,"We don't know what is wrong.He has been fine at home.This confusion just started 2 days ago and seems like it is getting worse." What is the most appropriate first response for the nurse to make?

A) "We will have to place him in temporary restraints for safety purposes."
B) "Can you tell me about his home medications and other illnesses he has?"
C) "Sometimes older people become more confused when they are away from home."
D) "He is 85 years old and this is the age group when Alzheimer's disease begins."

There are many factors such as medication toxicity,sensory deficits,and some physiological problems that contribute to confusion,delirium,and dementia in the older adult.Many of these factors are treatable once assessed and recognized.Polypharmacy is a risk factor for acute confusion,delirium,and depression in older adults and there is growing research in the area of pharmacogenomics.Therefore,the future of drug therapy for older adults will take into consideration DNA variants and individual response to medical treatment to identify particular subgroups of older adults and develop drugs customized for those subgroups. In this item,the first and most appropriate response by the nurse is to ask about medications and other health issues that could be causing or contributing to the confusion.The use of restraints draws scrutiny from many accrediting bodies and should be used only with proper documentation to support the need and only after other methods have been exhausted or proved not useful.