SeizureSafe™ Seizure Response
Module 2: Respond – What to Do During a Seizure
When a seizure occurs, quick and calm action can protect residents with dementia from serious harm. This module provides clear, step-by-step guidance for responding safely during and after a seizure. You’ll learn what to do, what to avoid, and how to ensure accurate reporting and follow-up.
Lesson 2.1: Responding When a Seizure Happens
Why Your Response Matters
Whether a seizure is subtle or dramatic, your actions can make the difference between safety and harm. You are not expected to diagnose or treat—that is the role of licensed clinical staff. But you are expected to remain calm, protect the resident, and report exactly what you see.
What to Do During a Seizure
- Stay with the resident and remain calm. Do not leave the room.
- Call for help or alert another team member if needed.
- Time the episode (even an estimate is valuable).
- Clear hazards from the area. If the resident is seated, support them to prevent falls. If they are on the floor and it is to do so, roll them onto their side to help keep the airway clear.
- Do not restrain movements. Focus on preventing injury, not stopping the seizure.
- Speak calmly and reassure the resident if they are responsive.
- Protect privacy and dignity. Close doors or curtains if possible.
What Not To Do
- Do not put anything in the mouth. It does not prevent injury and can cause choking or broken teeth.
- Do not leave the resident alone. Continuous supervision ensures safety and accurate reporting.
- Do not physically stop movements. Restraining can lead to injury.
- Do not ask questions mid-event. Wait until the seizure has ended.
- Do not assume it’s “just behavior.” Treat every episode as potentially significant.
After the Seizure Ends
- Stay with the resident and monitor recovery.
- Assist to a safe position if weak, confused, or disoriented.
- Notify the charge nurse or supervisor immediately.
- Prepare for documentation. Record what you saw, how long it lasted, and what the resident was doing before and after the event. See the Seizure Documentation module for detailed guidance.
Post-Seizure Protocol in Action
Use the Post-Seizure Safety Checklist (available in the Downloads section) to verify that all safety steps have been completed.
Remember
Even a brief episode matters. Reporting it early helps prevent future harm, supports accurate clinical follow-up, and protects the facility.
Think About This
If a resident became unresponsive for 30 seconds, would you know what to do? Would your report support clinical follow-up and protect the facility?
Lesson 2.2: Communication After a Seizure
Why Communication Matters
Clear, timely communication ensures that residents with dementia receive proper follow-up care, prevents misunderstandings, and protects the facility from regulatory or survey risk. When a seizure event is not reported accurately—or at all—important details are lost, potentially leading to missed diagnoses, family concerns, or compliance issues.
Who Should Be Notified
In SNF:
- Charge Nurse or Supervisor
- On-call NP or Physician
- Clinical Manager or Director of Nursing
In ALF:
- Wellness Director or On-Site Nurse
- Executive Director or Supervisor
- Family or Responsible Party (if policy requires)
Always document the time and method of notification. Never assume someone else has reported the event.
What to Say (and What Not to Say)
Do use clear, objective statements:
- “The resident stared for about 30 seconds and did not respond to verbal cues.”
- “Sudden right arm jerk, brief confusion afterward.”
- “The event lasted less than a minute, no injury observed.”
- “Resident was eating when the episode began, resumed activity after about 20 seconds.”
- “Unsteady when standing, appeared confused for 1-2 minutes after the episode.”
Avoid vague or subjective language:
- “It looked like a seizure.”
- “She had one of her episodes.”
- “Just acting out again.”
Describe what you saw, don’t diagnose.
What If You’re Not Sure It Was a Seizure?
Report it anyway. Even if uncertain, your observation helps the clinical team identify patterns: “Something about this seemed different than her usual behavior. I think it should be reviewed.”
Professional Tone = Team Culture
Reporting with a calm, factual tone sets the standard for team professionalism and accountability. Early, clear reporting helps ensure follow-up care and strengthens safety practices.
Seizure Event Communication Checklist
A step-by-step communication checklist is available in the Downloads section. For more guidance on documenting seizure events, see the Seizure Documentation module.
Think About This
Would you report a blank stare episode? Would your report be clear enough for action? Would your tone stay professional?
Lesson 2.3: Post-Seizure Monitoring
The Seizure May Stop—But Your Role Hasn’t
The postictal phase (after a seizure) often brings changes in alertness, behavior, or energy. Careful observation during this time is critical. Each resident with dementia may respond differently, and subtle symptoms can indicate ongoing risk.
What to Watch For
- Confusion or disorientation beyond the normal dementia behaviors
- Fatigue or drowsiness that does not resolve with rest
- Irritability, fear, or agitation
- Trouble speaking, memory gaps, or new verbal confusion
- Mild weakness, unsteadiness, or risk of falls
What Staff Should Do
- Stay close for 10–15 minutes or until stable
- Offer calm reassurance and limit unnecessary stimulation
- Assist with mobility or transfers if the resident is weak
- Avoid overwhelming the resident with questions
- Avoid overwhelming with questions
- Watch for delayed or unusual changes, and prepare to report them
- Begin preparing your observation for documentation (see Seizure Documentation module)
Handoff Best Practices
- Provide a clear, factual description of what happened
- Note any unusual post-event signs or behaviors
- Use consistent, neutral language for accuracy
- Flag changes that require follow-up
Example:
“Episode at 2 PM, staring for about 20 seconds. Confused afterward. Rested in bed, tired but stable. Documented and informed supervisor.”
Preparing for Documentation
- Observation continues after the seizure. Postictal notes are often most useful.
- Be honest, specific, and include the timeline.
- See Seizure Documentation for detailed recording and communication tips.
Post-Seizure Monitoring: Why It Matters
Subtle symptoms or secondary issues (like falls) can appear after the event. Calm, precise observation and early reporting reduce risk, improve care, and protect facility compliance.
Post-Seizure Monitoring Guide
A quick-reference monitoring guide is available in the Downloads section.
Think About This
How would you know a resident was truly stable after an episode? What changes would you watch for? Would your team know the next steps if another event occurred?
Module 2 Wrap-Up: Responding and Monitoring After a Seizure
What You Learned
- How to respond safely to seizures in residents with dementia
- Why calm, clear communication prevents harm and confusion
- How to identify postictal symptoms and report them effectively
- Best practices for handoffs during shift changes
- How to follow the chain of command for safety and compliance
Key Takeaway
The seizure may last only seconds, but what you do afterward determines the outcome. Observe, communicate, and document to ensure that no part of care is missed.
Next Steps
- Proceed to the Seizure Documentation module for detailed guidance on recording and reporting events.
- Revisit Seizure Recognition if you need to refresh on identifying seizure activity.