Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Assumptions

It is the consensus of the guideline development panel that the following assumptions are critical starting points for any nurse working with the older adult, and therefore were used as a framework for the development of this best practice guideline.

  1. Every older person has a right to timely, accurate and thorough mental health screening assessments when appropriate and related treatments are indicated.
  2. Delirium, dementia and depression are not synonymous with aging, but prevalence increases with chronological age.
  3. Screening assessments of geriatric mental health conditions must honour the older person’s preferences, values and beliefs and involve the individual in decision making.
  4. Healthcare professionals must at all times be sensitive, respectful and culturally aware to minimize the potential indignity of the assessment experience for the older person.
  5. Screening assessments of geriatric mental health conditions are complex and multi-faceted. They require specialized knowledge, skills and attitudes towards geriatric mental health, enhanced by a continuing relationship between nurse and client and refined through practical experience.
  6. Geriatric mental health assessments are enhanced when standardized assessment tools are utilized.
  7. Geriatric mental health screening assessments and care planning are most comprehensive when conducted from an interdisciplinary approach and when family/significant others are welcomed as partners in the process.
  8. Confounding factors such as age, education level, and cultural background should be considered in the selection of mental status screening assessment tools and in the interpretation of all assessment results/scores.
  9. Geriatric mental health screening assessment must be a dynamic and ongoing process that responds to the changing needs of the older person.