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3 stations / 23 steps/ 7 script lines

Geriatrics

Mind, mobility, medications, multi-complexity, and what matters most. The Confusion Assessment Method below can be covered and recalled feature by feature.

0 of 23 steps

5 Ms

The 5 Ms

  • MindWhat is the current mental status, and what is the underlying mental status?
  • MobilityAre there any issues with gait or balance? Can we put falls prevention in place?
  • MedicationsAre there any recommendations for rationalizing the medication list?
  • Multi-complexity: the whole picture of multiple comorbidities and the bio-psycho-social situation.
  • Matters mostIs the plan consistent with what this patient considers a meaningful health outcome? Are we matching their care preferences?

Confusion Assessment Method

Delirium is suspected with features 1 and 2 plus either 3 or 4.

RowWhat to ask or observe
1. Acute onset and fluctuating courseAcute change from baseline that comes and goes or varies in severity through the day; ask family or nursing
2. InattentionDifficulty focusing, easily distracted, losing track; months or days backward, digit span, serial sevens, vigilance tapping
3. Disorganized thinkingRambling or irrelevant conversation, illogical flow, unpredictable switching
4. Altered level of consciousnessAnything other than alert: vigilant, lethargic, stuporous, comatose

Demonstration videos are embedded from their creators’ own YouTube channels (Geeky Medics and Stanford Medicine 25) and remain theirs; each frame credits the channel and links out to it.