In this case, an 86-year-old man with a history of recurrent urinary tract infections (UTIs) is brought to the emergency room with altered mental status (AMS) and frequent falls. According to the patient's son, the patient had a significant decline and became more dependent in both his regular and instrumental activities of daily living. Upon admission, the patient was found to be in a hyperosmolar hyperglycemic state and eventually diagnosed with diabetes. A review of the patient's medications indicated that polypharmacy may be a contributing factor to his current mental status changes and falls. In addition, this case reviews the diagnosis of diabetes in an 86-year-old while reviewing the impact of polypharmacy in an older patient.