Early Nurse Detection and Management of Delirium

Inclusion Criteria: * Persons with dementia will be included if they: a) are on one of the selected medical-surgical units and are age 65 years or older; b) have been hospitalized less than 48 hours; and c) meet the criteria for dementia. The study will include minorities and women. Exclusion Criteria: * Persons with dementia will be excluded if they have any significant neurological or neurosurgical disease associated with cognitive impairment other than dementia (due to confounding with dementia or DSD), such as: * Lewy Body Dementia * Huntington's disease * Sormal pressure hydrocephalus * Seizure disorder * Subdural hematoma * Head trauma * Known structural brain abnormalities * Nonverbal and unable to communicate due to severe dementia (MMSE=0) * Aphasia * Intubation * Terminal illness (since interviews are required for the study). * This study will not exclude persons with pre-existing delirium. * In addition, subjects will not be excluded on the basis of race or gender.