How to screen for delirium (CAM)
Other platforms explain it with text and video. In VMS you practice it on the patient.
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
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]
Test attention
Ask the patient to name the months backward or say the days of the week backward. [1]
Check thinking
Listen for rambling, illogical ideas or switching topics. [1]
Check alertness
Note if the patient is very alert, sleepy or hard to wake. [1]
Score the CAM
Delirium is likely with acute change plus inattention, and either disorganized thinking or altered consciousness. [1]
Look for causes
Check for infection, medicines, dehydration, pain, low oxygen and urine retention. [2]
Report and act
Tell the provider and use prevention steps like reorientation, sleep and mobility. [1]
Common errors
- Assuming confusion is normal aging or dementia.
- Not asking family about the baseline.
- Missing the quiet, sleepy type of delirium.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
Facts and steps follow CDC STEADI (falls in older adults); NCSBN 2026 NCLEX-RN Test Plan. VMS is not affiliated with these organizations. Updated: 2026-10-11.