Voyer et al. (2006) recommend that when trying to detect
delirium in people with dementia it is important to monitor
attention, thinking, orientation memory and the fluctuation
of the symptoms rather than relying on psychomotor
symptoms such as hypoactivity and hyperactivity. The
documentation of symptoms of confusion is critical and
according to Voyer et al. (2006) recording these symptoms
as present or absent is inadequate and makes detection of
delirium in older people with dementia difficult as fluctuations
become impossible to notice. There are a variety of
mental status/neurologic assessment tools available to assist
nurses with assessment such as Folstein Mini Mental State
Examination (MMSE) (Folstein et al., 1975). However, it is
essential that nurses who use such tools are adequately
trained to carry out the assessment (Lemiengre et al., 2006)
and that they are aware of the limitations of the tool
(Foreman & Zane, 1996).