Jeanette Barber describes what information staff can elicit from those who know the patient best and how it can be applied in practice

It is well recognised that many older people have dementia but have never been investigated or received a formal diagnosis. If they are admitted to acute hospitals from their own homes or long-term care settings with confusion and little background information about their usual condition, it can be challenging for staff to determine if they have dementia, delirium, delirium superimposed on pre-existing dementia or confusion with a reversible cause such as vitamin deficiency. A careful history and information seeking from carers or family members about their loved one’s pre-admission baseline can inform nursing and medical assessments and help nurses to provide high quality care.