Screening for Delirium, Dementia and Depression in Older Adults

Nursing Best Practice GuidelineDepression: A syndrome comprised of a constellation of affective, cognitive and somaticor physiological manifestations.Family: Whomever the client defines as being family. Family members may include:spouse, parents, children, siblings, neighbours and significant people in the community.Focused History: A client history confined to questions designed to elicit informationrelated to cognitive impairment or a decline in function consistent with dementia and todocument the chronology of the problem.57Focused Physical Examination: A physical examination that seeks to identifylife-threatening or rapidly progressing illness, while paying special attention to conditionsthat might cause delirium. The examination typically includes a brief neurological evaluationas well as assessment of mobility and of cardiac, respiratory and sensory functions.Informal Support: Support and resources provided by persons associated with theindividual receiving care. Persons providing informal support may include: family, friends,neighbours and/or members of the community.Initial Assessment (for dementia): An evaluation conducted when the client,clinician, or someone close to the client first notices or mentions symptoms that suggestthe presence of dementing disorder. This evaluation includes a focused history, focusedphysical examination, examination of mental status and function and consideration ofconfounding and comorbid conditions.Instrumental Activities of Daily Living (IADLs): Complex, higher-order skillssuch as managing finances, using the telephone, driving a car, taking medications, planninga meal, shopping and working in an occupation.Interdisciplinary: A process where healthcare professionals representing expertise fromvarious healthcare disciplines participate in the process of supporting clients and theirfamilies in the care process.