Registered Nurses´ Association of Ontario
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Practice Recommendations
| Recommendation |
|---|
| 1.Nurses should maintain a high index of suspicion for delirium, dementia and depression in the older adult. |
| 2. Nurses should screen clients for changes in cognition, function, behaviour and/or mood, based on their ongoing observations of the client and/or concerns expressed by the client, family and/or interdisciplinary team, including other specialty physicians. . |
| 3. Nurses must recognize that delirium, dementia and depression present with overlapping clinical features and may co-exist in the older adult. |
| 4. Nurses should be aware of the differences in the clinical features of delirium, dementia and depression and use a structured assessment method to facilitate this process. |
| 5. Nurses should objectively assess for cognitive changes by using one or more standardized tools in order to substantiate clinical observations. |
| 6. Factors such as sensory impairment and physical disability should be assessed and considered in the selection of mental status tests. |
| 7. When the nurse determines the client is exhibiting features of delirium, dementia and/or depression, a referral for a medical diagnosis should be made to specialized geriatric services, specialized geriatric psychiatry services, neurologists, and/or members of the multidisciplinary team, as indicated by screening findings. |
| 8. Nurses should screen for suicidal ideation and intent when a high index of suspicion for depression is present, and seek an urgent medical referral. Further, should the nurse have a high index of suspicion for delirium, an urgent medical referral is recommended. |
