MAJOR CRITERIA
- Acute onset and fluctuating course
- Disorder of attention (inattention)
MINOR CRITERIA
- Disorganized thinking
- Alterations in sensorium
*diagnosis of delirium requires both major plus any one minor criteria
PATIENT ID
Chief Complaint*
* Need several iterations of the history, from several caregivers (may have large inter-observer differences in opinion)
History of Present Illness
- Onset Acute
- Chronic (acute if < 2 – 3 months, > 3 months represents a dementing state)
- Progress (gradual decline, static, rate of fluctuation)
- Palliating
- Precipitating
- Quality
- AIDS, altered LOC, disorientation, memory, psychomotor agitation/retardation, altered sleep-wake cycle
- Severity
- ADL → getting out of bed, using the bathroom, dressing, ambulation
- IADL → cooking, laundry, shopping, banking, paying bills, driving
- Safety concerns
- Cognitive function (MMSE)
- Symptoms
- Behaviour changes – agitation
- SAH → thunderclap headache
- Stroke → aphasia, paralysis
- UTI → dysuria
- Pneumonia → cyanosis, cough, sputum, fever
Functional History
- ADLs
- IADLs
- Behaviour changes
- Safety
Medication
- Benzodiazepines
- Beta-blockers
- Anticholinergics
Past Medical History
- Trauma
- Stroke
- CAD
- Endocrinopathy
- Kidney
- Psychriatric history
Family History
- Dementia
- Depression
Social History
- EtOH
- Social support (caregiver stress)
- Living arrangements
ROS
- Sleep pattern
- Visual changes
- Hearing loss
- Constipation
- Incontinence
Differential Diagnosis
- Drugs
- Infection
- Fluids/lytes
- Multiple
- Unknown