Long-Term Care Survey Alert

Use Section B5 of the MDS to detect signs of delirium in residents -- even those with dementia. The indicators of delirium - periodic disordered thinking/awareness include:
 
* Easily distracted (e.g., difficulty paying attention; gets sidetracked);

* Periods of altered perception or awareness of surroundings (e.g., moves lips or talks to someone not present; believes he/she is somewhere else; confuses night and day);

* Episodes of disorganized speech (e.g., speech is incoherent, nonsensical, irrelevant, or rambling from subject to subject; loses train of thought);

* Periods of restlessness (e.g., fidgeting or picking at skin, clothing, napkins, etc.; frequent position changes; repetitive physical movements or calling out);

* Periods of lethargy (e.g., slugishness; staring into space; difficult to arouse; little body movement);

* Mental function varies over the course of the day (e.g., sometimes better, sometimes worse; behaviors sometimes present, sometimes not).

Note: When assessing a resident with dementia for signs of delirium, pay attention to sudden changes in his usual functioning. For example, "a resident who is usually noisy or belligerent may suddenly become quiet, lethargic or inattentive," warns the Resident Assessment Instrument user's manual.