What is the primary indication for suspicion of sepsis in an elderly patient at a skilled nursing facility?

The primary indication for suspicion of sepsis in an elderly patient at a skilled nursing facility revolves around the presence of altered mental status, hypotension, and hot skin. This is particularly important because elderly patients often do not exhibit classic signs of infection like a high fever. Instead, they may present with subtle changes in mental status or decreased blood pressure, which can be indicative of a systemic response to infection—characteristics commonly associated with sepsis.

Altered mental status may manifest as confusion or disorientation, which can sometimes be mistaken for other conditions common in elderly patients. Hypotension is a critical sign of septic shock, reflecting the body’s inability to maintain adequate blood flow and perfusion due to infection. Hot skin, meanwhile, might suggest vasodilation that can occur in response to infection. Collectively, these signs provide a more reliable indication of sepsis, allowing for timely recognition and treatment, which is crucial for improving patient outcomes.

In contrast, while a high fever can be associated with sepsis, many elderly individuals do not exhibit a fever due to blunted physiological responses. Complete blood count results can aid in the diagnosis but are not direct indications on their own. The presence of a family member is not a clinical indicator of sepsis and