Screening for Delirium, Dementia and Depression in Older Adults
Screening for Delirium, Dementia and Depression in Older Adults
Screening for Delirium, Dementia and Depression in Older Adults
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Nurs<strong>in</strong>g Best Practice Guidel<strong>in</strong>eResponsibility <strong>for</strong> DevelopmentThe Registered Nurses Association of Ontario (RNAO), with fund<strong>in</strong>g from theOntario M<strong>in</strong>istry of Health <strong>and</strong> Long-Term Care, has embarked on a multi-year project of nurs<strong>in</strong>gbest practice guidel<strong>in</strong>e development, pilot implementation, evaluation <strong>and</strong> dissem<strong>in</strong>ation.<strong>Screen<strong>in</strong>g</strong> <strong>for</strong> <strong>Delirium</strong>, <strong>Dementia</strong> <strong>and</strong> <strong>Depression</strong> <strong>in</strong> <strong>Older</strong> <strong>Adults</strong> is one of six best practiceguidel<strong>in</strong>es developed <strong>in</strong> the third cycle of the project. The RNAO convened a panel to developthis guidel<strong>in</strong>e, conduct<strong>in</strong>g its work <strong>in</strong>dependent of any bias or <strong>in</strong>fluence from the M<strong>in</strong>istry ofHealth <strong>and</strong> Long-Term Care.Purpose <strong>and</strong> Scope15This guidel<strong>in</strong>e has been developed to improve the screen<strong>in</strong>g assessment of olderadult clients <strong>for</strong> delirium, dementia <strong>and</strong> depression. This guidel<strong>in</strong>e does not <strong>in</strong>cluderecommendations <strong>for</strong> the management of these conditions <strong>in</strong> day-to-day nurs<strong>in</strong>g practice.Best practice guidel<strong>in</strong>es are systematically developed statements to assist nurses <strong>and</strong> clients<strong>in</strong> decision mak<strong>in</strong>g about appropriate healthcare (Field & Lohr, 1990). This guidel<strong>in</strong>e focuses on:(1) Practice recommendations: directed at the nurse to guide practice regard<strong>in</strong>g assessment<strong>and</strong> screen<strong>in</strong>g <strong>for</strong> delirium, dementia <strong>and</strong> depression <strong>in</strong> older adults; (2) Educationrecommendations: directed at educational <strong>in</strong>stitutions <strong>and</strong> organizations <strong>in</strong> which nurseswork to support its implementation; (3) Organization <strong>and</strong> policy recommendations: directedat practice sett<strong>in</strong>gs <strong>and</strong> the environment to facilitate nurses’ practice; (4) Evaluation <strong>and</strong>monitor<strong>in</strong>g <strong>in</strong>dicators.Although this guidel<strong>in</strong>e is written to guide nurs<strong>in</strong>g practice, geriatric mental healthcare is an<strong>in</strong>terdiscipl<strong>in</strong>ary endeavour. Many sett<strong>in</strong>gs have <strong>for</strong>malized <strong>in</strong>terdiscipl<strong>in</strong>ary teams <strong>and</strong> thepanel strongly supports this structure. Collaborative assessment <strong>and</strong> treatment plann<strong>in</strong>gwith the client <strong>and</strong> family are essential.It is acknowledged that the screen<strong>in</strong>g <strong>for</strong> delirium, dementia <strong>and</strong> depression needs to bestudied <strong>in</strong> a more clearly def<strong>in</strong>ed way, <strong>and</strong> that there are gaps <strong>in</strong> the research evidence.However, this guidel<strong>in</strong>e will enable nurses to apply the best available evidence to cl<strong>in</strong>icalpractice, <strong>and</strong> to promote the most appropriate use of healthcare resources.
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