Editing Mental Health and Psychosocial Nursing (section)

== Neurocognitive Disorders: Delirium, Dementia, and Depression ==
{| class="wikitable"
! Feature !! Delirium !! Dementia (major neurocognitive disorder) !! Depression
|-
| Onset || Acute, hours to days || Insidious, months to years || Weeks
|-
| Course || Fluctuates, worse at night (sundowning) || Progressive, stable within a day || Fairly constant, often worse in the morning
|-
| Consciousness || Impaired, fluctuating attention || Clear until late stage || Clear
|-
| Reversibility || Usually reversible if cause is treated || Usually irreversible || Reversible with treatment
|-
| Memory || Immediate and recent impaired || Recent then remote impaired || Inconsistent; "I don't know" answers
|-
| Priority || Find and treat the cause || Safety, function, caregiver support || Safety and mood treatment
|}

Delirium is a medical emergency and is commonly caused by infection (especially urinary tract infection in older adults), hypoxia, electrolyte disturbance, hypoglycemia, dehydration, pain, medication effects (anticholinergics, benzodiazepines, opioids), substance withdrawal, and urinary retention or constipation. '''New confusion in an older adult is delirium until proven otherwise.'''

Dementia care: consistent caregivers and routine, simple one-step directions, familiar objects, adequate lighting, reduced clutter and noise, validation rather than reality orientation in the later stages, redirection instead of confrontation, and safety measures for wandering (door alarms, identification bracelet, secured exits). Support the caregiver; caregiver burden is a nursing diagnosis in its own right.