Screening for Delirium, Dementia and Depression in Older Adults

Nursing Best Practice GuidelineGuiding Principles – AssumptionsIt is the consensus of the guideline development panel that the followingassumptions are critical starting points for any nurse working with the older adult, and thereforewere used as a framework for the development of this best practice guideline.1. Every older person has a right to timely, accurate and thorough mental health screeningassessments when appropriate and related treatments are indicated.112. Delirium, dementia and depression are not synonymous with aging, but prevalenceincreases with chronological age.3. Screening assessments of geriatric mental health conditions must honour the olderperson’s preferences, values and beliefs and involve the individual in decision making.4. Healthcare professionals must at all times be sensitive, respectful and culturally aware tominimize the potential indignity of the assessment experience for the older person.5. Screening assessments of geriatric mental health conditions are complex and multi-faceted. Theyrequire specialized knowledge, skills and attitudes towards geriatric mental health, enhancedby a continuing relationship between nurse and client and refined through practical experience.6. Geriatric mental health assessments are enhanced when standardized assessment tools are utilized.7. Geriatric mental health screening assessments and care planning are most comprehensivewhen conducted from an interdisciplinary approach and when family/significant othersare welcomed as partners in the process.8. Confounding factors such as age, education level, and cultural background should beconsidered in the selection of mental status screening assessment tools and in theinterpretation of all assessment results/scores.9. Geriatric mental health screening assessment must be a dynamic and ongoing processthat responds to the changing needs of the older person.