Delirium and dementia history

Question 1

What are the questions to ask specifically for acute confusion?

Answer 1

delirium questions:

• confusion-did you notice any change in his behaviour? is he aware of where he is at the moment/time/date?
• inattention-did he find it difficult to follow the conversation? did he get distracted quite easily
• disorganized thoughts-any changes in his speech that you notice
• hallucinations-did he describe things that others can’t see? did he hear things that others can’t hear
• physical activity- any changes that you notice in his physical behaviour? withdrawn/agitated? able to eat/dress himself?

Precipitants

• fever, night sweats and weight loss
• any difficulty with water works/bowel habits
• chest pain/shortness of breath
• checking for medication (that can exacerbate this)

Question 2

What are the questions to ask for dementia?

Answer 2

PC:

• cognition-does he have trouble remembering things? (anterograde/retrograde) does he have trouble recognizing familiar faces or objects (stereognosia)
• executive function-any difficulty with planning and organising activities? has he ever gotten lost before
• any changes in his behaviour that you notice-aggressive towards family members etc
• any difficulties with simple tasks (apraxia)
• hallucinations-is he seeing things that other’s can’t see and hearing things that other’s can’t hear

PMH/SH:

• head trauma
• history of parkinson’s
• vascular risk factors

DH/FH

LH (very important):

• type of accomodation and adaptations
• assess need for carer
• occupation