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The doctor sits down to get a better look at the patient and engages with her. He responds to subtle clues of confusion (uncertainty about why she is there.) and initiates screening using some components of standardized screening (test of short-term memory, orientation). He is aware that dementia is common in older ED patients and is careful to include it as part of his differential diagnosis. It may have taken a bit longer, but the outcome was significantly different and an early return to ED was avoided.
This patient’s daughter was contacted by ED staff. She came and said that there wasn’t much different from usual with her mother and took her home. She expressed gratitude for looking after her mother so well.
What do you think is missing from this assessment? What would you do differently?
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