Table of Contents IntroductionPresenting complaintHistory of presenting complaintPast medical historyDrug historyFamily historySocial historyEndingWhy don’t you test your knowledge? Introduction Wash handsIntroduce selfAsk Patient’s and relative’s namesExplain the need for a collateral historyEstablish their relation to the patient Presenting complaint Confusion/memory loss History of presenting complaint Onset: determine if it is acute, chronic, or acute-on-chronic (establish baseline function and cognition)Progression: slowly progressive (Alzheimer’s), step-like (vascular)Triggers: infection, stressAssociated symptomsDepressionPsychiatric symptoms: hallucinations/delusionsBehavioural change: agitation, aggression, wandering, disinhibition, calling outSleeping pattern: awake at night (Alzheimer’s), early morning waking (depression), fluctuating consciousness (delirium)Cognitive disturbances: aphasia, apraxia, agnosia, difficulty planning/organising Past medical history Ask about: Parkinson’s disease, vascular disease/diabetes, head injuries, recent infectionsPsychiatric history Drug history Blood pressure/diabetes medicationParkinson’s drugsAlzheimer’s drugs: galantamine, donepezil, rivastigmineNew medicationsAllergies Family history Related conditions, e.g. dementia, vascular disease, depression Social history Living situation, carer/home supportMobility/walking aidsEffect on function/coping with activities of daily living: washing, dressing, cooking, cleaningWorking/drivingSmoking, alcohol and other cardiovascular risk factorsRISKTo self: wandering, leaving gas on, abuse, neglect by self or othersTo others: aggression, risky behaviourCarer’s needs: empathise with the demands; ask about stress, coping, and support Ending ICE (Ideas, Concerns, Expectations): how does the relative/carer expect you to help? What are they worried about?Summarise situation and patient needs. Thank relative. Causes of dementia Oops! This section is restricted to members. Why don’t you test your knowledge? What are the defining clinical features of delirium? Oops! This section is restricted to members. What are the possible causes of delirium? Oops! This section is restricted to members. How would you assess a patient’s capacity? Oops! This section is restricted to members.