5. Skilled interventions and teaching

Skilled interventions

• Assess cognition against the baseline each shift and screen for delirium (CAM); document the comparison.
• On an acute change, initiate the delirium workup per order and screen for the treatable trigger; escalate with a closed loop.
• Implement non-pharmacologic delirium measures (reorientation, sensory aids, sleep-wake support, mobility, hydration) and safety measures.

Teaching / training (to mastery)

• Teach the resident/representative the difference between dementia and delirium, the plan, and the warning signs of an acute change, with teach-back.
• Train CNAs to recognize and report an acute change from baseline and to use reorientation and safety measures, with documented understanding.