Related Resources
Downloads
- Delirium Pre-Printed Order Set – PDF
Links
- The Mini-Cog as a Screen for Dementia – Borson, Scanlan et al. JAGS, October 2003, 51 (10) 1451–1454
- Four Sensitive Screening Tools to Detect Cognitive Dysfunction in Geriatric Emergency Department Patients: Brief Alzheimer’s Screen, Short Blessed Test, Ottawa 3DY, and the Caregiver-completed AD8 – Carpenter, et al Acad Emerg Med; 2011, 18: 374-384
- The Assessment and Treatment of Delirium in Older Adults – Pocket Version from the Canadian Coalition for Seniors’ Mental Health.
- AFP Screening Tools for Cognitive Impairment – CARLAT, Am Fam Physician. 1998 Nov 1;58(7):1617-1624.
- Validation of a Brief Screening Tool to Detect Depression in the Older Patient – from Science Direct: Fabacher et al Am J Emerg Med 2002;20:99-102
Recommended Readings
- Altered Mental Status in Older Emergency Department Patients. Wilber, Scott T. Elsevier Saunders – View the article.
- Does this Patient Have Delirium? The Value of Bedside Instruments. Wong, CL et. al. 2011 – PDF
Discussion: Related Resources
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no
resources are invaluable, but as described in the beginning, often very time consuming
collateral info from family is invaluable
asking the patients at same age about there concerns
listening to family/caregiver concerns, cues as laid out in module
I just try to be clear in my notes and establish the baseline cognitive condition of the patient
OK
Using non verbal cues to reach out to a diagnosis is important as well
resources
Nothing different
good information
Mini cog
quite valuable and extensive resources have been shared in this module
nothing to add
resources
3 Ds very important
good information
ok
Pharmacists often have help de-prescribing clinics in our health-care authority that are under-used. Utilizing this valuable resource gains specialist-level knowledge and saves clinic time.
interesting, i have not heard of this before
agree
yup
thank you!
ok
reviewed
noted
reviewed
reviewed and learned a lot
reviewed
rewviewed
reviewed
reviwed
i would read further on topics provided
great topic
I would love to see the CAM used more often, particularly since delirium is missed so often.
none
ok
https://www.health.harvard.edu/staying-healthy/when-patients-suddenly-become-confused
thanks
review info before seeing pt.
Ok
Nothing different
ok
ok
okay
3
ok
social work
ok
Resources are always helpful but most be used with the patient and the patient must be willing to participate.
yes
.
ok
No additional resources, involve family/social work early
very informative
Excellent resources
we use MOCA test
great
.
great tools
it’s a wonderful resource to learn about 3Ds among older patients
Good
nice
good
.
Good info
well done
https://ccsmh.ca/en/projects/delirium.cfm this link is not abailable
nothing to add
.
.
…
great
.
yes
better communication
Extra resources are always helpful
Nothing to add.
Nothing to add. Thanks!
Nothing to add
.
OK
Good
Super helpful
nothing else to add
I have no other resources to add at this time.
Nice module
Good tips
Fantastic module!
It is really helpfull since provide doctors in ED with operative, effective and no time consuming tools to explore this esential element of elderlys’ health.
ok
at present no
No
great module
I was a good module with valuable information.
These are valuable information. Will definitely use this in the ED
Yes we do
We have lo geriatric acute team but also well developed screening tests
nice module
Drug review interaction and supplements.
nothing to add
dsfsdf
GPA
I do not
Great links
great information
Alzheimer’s association
Super helpful.
very good module
Si en estos momentos tengo un recurso valioso para abordar de forma más eficiente a los pacientes geriátricos en la sala de emergencia
this module was very insightful. I learned from the articles posted, the videos, the expert feedback and the discussion provided much clarity and will definitely support my practice using these new tools for identifying an distinguishing between the 3D’s. Thanks!
Great module
nicely set up and broken down for easy reading.
nothing different. These resources are great!
Very Helpful
GPA; P.I.E.C.E.S.; montessori techniques; recreation therapy (referral)
GPA(gentle persuasive approach) Dealing with patients experiencing delirium and dementia
agreed!
These assessments should be conducted whenever we suspect any change from baseline
these are great
Helpful
Excellent.
sure
.
np
Let us know if you have a valuable resource relating to cognitive impairment of older adults in the ED. We’d love to hear about it.
Not an assessment tool but we have an activity box. colorful large gadgets, picture books, large dominoes and cards, also a music player to either calm or keep busy which ever seems to work.
helpful resources
these extra resources are extremely helpful
Thank you! very informative module
thanks
Thank you for a wonderful module!
nothing to add, did learn a lot form the module and group post. Thanks.
Great information to have.
important
na
Thank you. RISKS
ISAR score. RN’s and case management very helpful as well in assessment/dispo of patients
Older person assessment scale
none
n/a
nothing to add
The Assessment and Treatment of Delirium in Older Adults – Pocket Version from the Canadian Coalition for Seniors’ Mental Health.
Link no longer exists
geri acute team
gpa
happy to have geriatrics on our team
GPA
listening to elder’s feelings and thoughts. Improved validations.
important
GPA
communicate with the LTC staff
GPA e-learning
interesting
GPA
Gentle Persuasive Approach
not suitable for ED but may be in office
helpful1
1
helpful
GPA
GPA – Gentle Persuasive Approaches
Good information!
Useful resources!
nice
Thank you
Ok
tuganom August 28, 2018
This link: The Assessment and Treatment of Delirium in Older Adults – Pocket Version from the Canadian Coalition for Seniors’ Mental Health.
Does not work anymore.
thanks
thank you
This link: The Assessment and Treatment of Delirium in Older Adults – Pocket Version from the Canadian Coalition for Seniors’ Mental Health.
Does not work anymore.
HELPFUL
n/a
nothing to add
Similar to others, I have found this to be the most useful tool for assessment that I have found so far.
.
not yet
NO
Na
N/A
Not currently, have learned some new things to try from this module
not at this moment
nothing to add
Input from family and caregivers is very useful.
MoCA – I like that it’s available in several languages and has an instruction sheet for the medical provider.
In my 24 years as a paramedic that family is a crucial source of information in pt’s with cognitive impairment especially when trying to rule in and rule out.
Patient himself/herself
Collaterals from family and friends
Previous MMSE or other screening records
Letters from the GP and Geriatrician
Previous ACAT assessment
The most valuable resource is the patient’s family/collateral information
Getting family involved
excellent articles.
..
involve family. use your support staff
Detailed history taking and using these screening tools are invaluable.
The link for The Assessment and Treatment of Delirium in Older Adults – Pocket Version from the Canadian Coalition for Seniors’ Mental Health needs to be updated. Thanks!
great review
excellent tools to have
I have nothing useful to add, in fact, I found this presentation and the discussion groups provided me with more useful tools than I previously had in my toolbox. Thanks!
minimental
slums
I have nothing to add except that collateral information from relatives, friends is invaluable. If a frail elderly person came in alone, I would make an effort to trace the neighbour/relative, someone before letting them go home even if the cause was identified.
Nothing to add.
nothing to add at this time
Mini Cog,MMSE,CAM
And I agree with the MoCA comment above, the ED is not the place to do a more formal assessment such as a MoCA, considering there are many factors affecting the patient’s cognitive assessment…better to leave the MoCA and more formal testing for the inpatient unit or even better for out the outpatient clinic and then re-evaluate over time.
Thanks for the organized list of resources, good to have quick access to these.
MOCA test – longer test – perhaps not suitable for ED but may be in office
no
aeioutips
ok
I DON’T
very good module
I like to rely on my colleagues. I work with some pretty smart people.
I do not
.
not at this time
not at this time
no
no
Nope.
We sometimes use the mini-Geriatric Depression Scale (1 point questionnaire) but it’s a bit too long for routine use in the ED.
A – alcohol (including withdrawal)
E – epilepsy (especially post-ictal)
I – infection
O – oxygen (hypoxia)
U – uremia
M – myocardial infarction
& – anesthesia
M – metabolic
T – trauma/fracture
I – insulin
P – polypharmacy
S – stroke
great extra information for assessing patient.
AEIOU and TIPs.
in my department do not exists
now I do not have the resources but can investigate the matter
I have no knowledge but should be investigated
but right now there investigare
Got the evaluation tools.
Using mini cog as well
🙂
Nope
none
This is helpful.
nope
good assessment tools
xx
Doing a more thorough assessment of the 3 D’s will be a change in my practice going forward. We are all responsible for our patients!
Definitely will
I always try to go through the mnemonic AEIOU M&M TIPS ,in addition to gather more information from other resources when it comes to geriatric pts.
Mnemonic for differential diagnosis of delirium – AEIOU M&M TIPS
A – alcohol (including withdrawal)
E – epilepsy (especially post-ictal)
I – infection
O – oxygen (hypoxia)
U – uremia
M – myocardial infarction
& – anesthesia
M – metabolic
T – trauma/fracture
I – insulin
P – polypharmacy
S – stroke
Nothing different
For outpatients, I try to get the family involved ahead of time. I inform them of signs to look for, advise them of any safety issues to fu sooner. OFten when the family is aware of what to look for we can avoid a lot of acute events.
Our community partner, Geriatric Outreach team will be consulted if needed to perform cognitive testing (MMSE) in the patient’s home where there is less of environmental distraction and more privacy. It seems more accurate than doing these tests in ED.
WE have geriatric acute care teams who do these assessments for us
communicate with the LTC staff that know them
i prefer to do formal cognitive functional assessments and a review of the medical surgical history, drug review also interview family and caregivers so i can get a better understanding of their issues
I make an effort to do the review of history, drug review BEFORE I see the patient. There is often a lot of information available (old chart, medication registry,etc) that contributes to my initial assessment.