Delirium superimposed on dementia: an acute change from the dementia baseline — new fluctuating attention, increased confusion, and disorganized thinking (a positive CAM), different from the chronic baseline — concerning for a treatable acute illness. A delirium workup initiated per order (vitals, glucose, oxygen, infection and medication screen), the provider notified with the change, orders received, the responsible party notified, non-pharmacologic measures intensified, and an unnecessary psychotropic avoided. Will reassess and evaluate for a Significant Change assessment; supports the Section C update. Skilled recognition of delirium versus the dementia baseline required. (The workup routes to the Cognitive reference.)

New or dangerous BPSD escalation: a new escalation of agitation/aggression creating a safety risk (to self or others), not explained by the baseline. Screened for a medical or environmental trigger (pain, infection, constipation, hypoxia, overstimulation) rather than reflexively medicating, a skilled non-pharmacologic behavioral plan implemented, the provider and team engaged, safety measures put in place, and any psychotropic use justified and monitored per the Behavioral standard. Will reassess; supports the Section E update. Skilled behavioral management required. (Psychotropic/GDR detail routes to the Behavioral reference.)