DiraChart · Clinical Reference · Read-only baseline inherited by all agencies
Core Assessment Domain · 2.10
Cognitive / Mental Status
Orientation, memory, attention, and executive function, and the recognition of delirium versus dementia versus depression — assessment and the skilled response that protects safety and supports capacity.
Psychiatric / Mental Health · Neurological · Safety · Function (ADL / IADL) · General / Constitutional · Communication · Foundations apply to every visit.
How to use this module
This module supplies cognitive and mental-status assessment and the skilled language that proves it required a licensed nurse — orientation, memory, attention, and executive function, the delirium-versus-dementia distinction, and the safety and capacity implications of impairment. Mood and depression are assessed in Psychiatric / Mental Health, the neurologic examination in Neurological, the safety impact in Safety, and the functional impact in Function. The most important judgment this module supports is recognizing acute change — delirium — as a medical emergency to evaluate. Each narrative is a structured example to be edited to the actual visit.
