Emergency admission of at risk elderly patient1

Suspect confusion?
Perform CAM

Physical examination
Bloods2 ECG Urinalysis CXR CT
Brain as appropriate
Perform AMT & CLOX

Collateral history from If negative manage

GP/family/carers according to delirium
Perform IQCODE SF guidelines3

Severe behavioural disturbance or

Yes
likelihood of deprivation of liberty?
URGENT referral to
Hospital Mental health
Team
No

Treat acute illness

Establish baseline level of function and
supports
Mental capacity assessment
Deprivation of liberty assessment
MUST, Continence assessment
MMSE, GDS

Review physical and cognitive

function regularly MMSE, Repeat
AMT, EMS, Barthel

Back to baseline?

No

Yes Physical problems

predominate?

Restart Care Yes No

Package if
applicable

Return to previous address Intermediate Hospital Mental Health

Copy summary to GP, CMHT, Memory Clinic, Care/reenablement Team referral
Dementia Advisor, Community Matron as Specialist investigation
appropriate