You are assessing an elderly patient overnight staff describe as 'confused and frightened.' Before revealing the answer, decide how you would assess specifically for a dream-like change of consciousness.

Assess orientation for time, place, and person specifically, noting the characteristic preservation of orientation for person even when time and place are lost. Ask gently and specifically about visual experiences, including any sense of seeing animals or small creatures, and about the person's emotional reaction to them. Note whether the disturbance fluctuates over the day, since a characteristic worsening at night with some improvement by morning is a useful clinical clue pointing toward this pattern.