Ensure the patient is wearing glasses and/or hearing aids if required and assess the need for an interpreter.
Daily testing may be indicated during hospital admission
The diagnosis of delirium requires the presence of features 1 and 2 and either 3 or 4.
CAM assessment test
feature 1:
Acute onset and fluctuating course
Information usually obtained from positive responses from family / carers when asked:
Questions:
Was there an acute or sudden change in the person’s mental status / the way s/he usually is?
Did the abnormal / strange behaviour fluctuate during the day / come and go / increase and decrease in severity?
feature 2:
Inattention
Did the person have difficulty focusing attention?
Ie. Easily distractible or having difficulty keeping track
feature 3:
Disorganised thinking
Was the person’s thinking disorganised or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas or unpredictable switching from one subject to another?
feature 4:
Altered Level of Consciousness
Overall, how would you rate the person’s level of consciousness? Alert / normal, vigilant / hyper-alert, drowsy, easily aroused, stupor / difficult to arouse or coma / unrousable.