Delirium and Acute Problematic Behavior
Altered mental state (AMS) is not a disease but a symptom or syndrome. It means a significant change in alertness, mood, or cognition that impacts an individual's function, comfort, safety, or social interactions. It always has a cause, such as an acute or chronic medical or psychiatric condition, trauma, environmental stress, or an adverse effect of a medical intervention such as a surgical procedure or a medication. An AMS may disrupt or threaten the health or safety of the individual and possibly others.
Many individuals living in long-term care facilities have significant impairment of mood, cognition, or behavior. The frail elderly are at risk for additional symptoms and condition changes as well. Therefore, long-term care facility staff and physicians must be able to understand AMS, identify its presence, determine its significance, and manage it appropriately. The purpose of this guideline is to give health care practitioners and other members of the interdisciplinary team a basic process to effectively assess and manage patients with new or ongoing AMS, in order to maximize function and quality of life and minimize risks, complications, functional decline, hospitalization, and death. The guideline is not meant to be a definitive treatise on AMS; it should be used in conjunction with other references.
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