00:01
We also want to be looking
at their attitude
as well as their
level of consciousness.
00:06
So what about their attitude?
We are going to observe
an attitude.
00:13
Do they have an open attitude?
Are they willing to talk to us?
Are they sitting down and sort of,
"Hey, how you doing?"
Yeah, so one of the questions.
I've been here before.
00:26
Are they quite secretive?
I really rather not speak louder
than this. If it's okay with you.
00:37
People are listening.
00:39
They're giving you
a secret of attitude?
Are they being cooperative?
When you're asking them
to do things,
are they saying,
"Sure, I can do that?"
Are they being suspicious?
Hmm.
00:56
Are they apathetic?
Do they seem not to care
at all about what's going on?
Or are they kind of giving you
the evasive moves?
So you ask them a question?
It's like, "I don't know about that.
01:10
But and they'll start talking about
something else.
01:15
Are they able to focus?
Is their attitude focused?
I'm here for this reason.
I really want this to happen.
01:22
This is where
we're going to be moving.
01:24
This is an attitude.
01:27
We know how to assess
level of consciousness.
01:30
We do it all the time.
01:32
On med surg floors,
we do it in the emergency room,
we do it post operatively.
01:38
Is the person that we're looking at,
are they alert?
Are they answering us?
Are they drowsy? Are they vigilant?
Are they looking around?
Are they, is that level of
consciousness fluctuating?
Are they alert for a little while
and then suddenly,
they start getting drowsy?
And then they're alert again?
Are they confused? Is the person
unable to gather their thoughts?
Are they stupurous?
Are they unable to respond to us?
Is the person comatose?
When would hope not.
02:15
But we do have some patients
who appear to be almost comatosed,
Their level of consciousness
seems to be as though
they are not even in our
same reality not moving.
02:29
We have to assess.
02:30
We want to look for changes
and level of consciousness
for a number of reason.
02:35
One, because it might indicate
where they are, psychologically,
but also have they take in
some kind of drugs
that have changed
their level of consciousness?
As we are assessing them, are they
changing the level of consciousness?
Are we facing somebody
who is becoming delirious,
these are extremely important.
03:18
We also want to know
their orientation.
03:22
We want to know
if they're oriented to person.
03:24
We will say to them,
what's your name? Who are you?
Do you know
where you are right now?
We want to know that they
are oriented to place.
03:34
We want to know that
they're oriented to time.
03:36
Do you know what year it is?
These are extremely important.
03:42
We also want to know however,
are they oriented to current events?
And this is a difficult one.
03:49
We might want to ask them
who the president is.
03:52
But make sure it's not a year
where there's a
change in presidents
because they might be
confused to that.
03:59
You might be able to ask them other
questions that perhaps are easier.
04:04
Now, who is the
governor of your state,
if the governor has been
the governor for a while?
Current events are also quite
different for those people
who have beginning dementia.
04:16
And they may be going back
to events from way past.
04:23
We also want to find out
if they have insight.
04:27
One of the things that really
identify psychiatric patients
who are in need of help
is their lack of insight.
04:37
You say, "Why are you here?"
And they say,
"I haven't got a clue.
04:43
There is nothing wrong with me.
04:46
But my family thinks
I should be here
and I just want to humor them."