The assessment of NCS is key to its successful management. The following three steps should always be followed when caring for a person with behavioural or psychological symptoms.

Step 1: Out-rule a delirium

• Does the patient have an underlying acute medical condition? e.g. UTI, chest infection
• Is there another potential causes of an abrupt change in behaviour? e.g. stroke, encephalitis, meningitis.
• Physical Exam: Note consciousness level, vital signs, examine for signs of pulmonary infection, urinary retention, impaction
• Request MSU

Step 2: Identify target behaviour

• What symptom or behaviour are you attempting to treat, and why?
• Have a clear description of the problem at hand;
  • When did the behaviour begin? Frequency? Time of day? When does it not occur?

Step 3: Identify any possible triggers for the behaviour

Behaviour can often be a form of communication. Consider the following triggers:

• Is there an unmet physical need?
  •  Pain? Constipation? Injury? Cold? Hunger? Thirst?
• Iatrogenic cause?
  • Inappropriate medication (see link below to our list of inappropriate medications in dementia) or potential side effect of a new medication  
• Environmental trigger?
  • Noise? Over/under-stimulation? No wandering space?
• Psychosocial factors?
  • Boredom? Loneliness? Staff/Carer Communication?