A patient arrived at the TriHealth Evendale Hospital pre-op area for a total hip procedure Jena Newport noticed his persona was somewhat off; he had difficulty signing his consent form, following easy instructions and answering questions. He was also tachycardic and his demeanor was of a known dementia. Upon questioning his significant other, she said his behavior was not normal for him and it started 2 days ago. Earlier that morning she asked him about the "X" to mark the correct hip but he didn't know what she was talking about. He also got lost coming to the facility. Jena alerted anesthesia concerning these findings. The doctor interviewed the patient and the patient could not tell her his children's names. The procedure was canceled. Jena and the doctor called report to Bethesda North ED, he was transported via TriHealth Transport.