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Older adult care

How to screen for delirium (CAM)

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPANursing (NCLEX)
Practice it in VR with Blocky

Delirium is a sudden change in attention and thinking that is common in sick older adults. It is often missed but is linked to falls and death.

Step by step

  1. Ask about acute change

    Ask family or staff if the patient's mental state changed suddenly or goes up and down during the day. [1]

  2. Test attention

    Ask the patient to name the months backward or say the days of the week backward. [1]

  3. Check thinking

    Listen for rambling, illogical ideas or switching topics. [1]

  4. Check alertness

    Note if the patient is very alert, sleepy or hard to wake. [1]

  5. Score the CAM

    Delirium is likely with acute change plus inattention, and either disorganized thinking or altered consciousness. [1]

  6. Look for causes

    Check for infection, medicines, dehydration, pain, low oxygen and urine retention. [2]

  7. Report and act

    Tell the provider and use prevention steps like reorientation, sleep and mobility. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

20 Making Synapses cases train this skill: open the case library

Sources

  1. NCSBN 2026 NCLEX-RN Test Plan
  2. CDC STEADI (falls in older adults)

Facts and steps follow CDC STEADI (falls in older adults); NCSBN 2026 NCLEX-RN Test Plan. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.