![]() While Alzheimer’s disease is a common cause of dementia, it’s important to dig deeper, advises the National Institute on Aging. Behavioral problems such as agitation and aggression among nursing home patients with dementia are key concerns as well. For example, a patient may have a co-occurring illness, a neurological condition, traumatic brain injury, or mental health condition such as depression. It’s important to recognize that some degree of cognitive impairment or dementia may be layered with other conditions. They recommend using “multiple assessment methods when possible, including reviewing records, clinical interviewing, direct behavioral observation, self-report, informant report, assessment instruments as indicated, electronic activity and sleep monitoring, and psychophysiological techniques.” The need for neurobehavioral evaluationīeyond cognitive assessment alone, a comprehensive evaluation takes into account psychological and adaptive functioning, according to Psychologists in Long-Term Care. An advantage of the full MOCA is that it provides more assessment levels, whereas the MOCA - short provides only two. Thus, when a MOCA–short score is anything less than perfect, GuideStar practitioners move directly into a MOCA-full assessment. Thus, it’s quite sensitive in picking up even mild cognitive issues. The MOCA assessment is very focused on executive functioning. Other versions of the MOCA are MOCA-blind (for individuals with vision impairment), MOCA-short (an abbreviated version of the MOCA-Full), and MOCA-mini (an abbreviated version that omits executive function and drawing items). Montreal Cognitive Assessment – Full (MOCA-full), a quick assessment measure for mild cognitive dysfunction, which assesses cognitive domains of executive functioning, visuoconstructional skills, language, attention and concentration, conceptual thinking, calculations, orientation, and memory.Folstein Mini-Mental Status Exam (MMSE), a quick assessment tool for dementia, which assesses cognitive domains of orientation, language, memory, attention, calculation, registration, following simple commands, and visuoconstruction.Brief Interview for Mental Status (BIMS), a screening measure to assess cognition.Some of the common tools for cognitive assessment include: They add: “The failure to evaluate memory or cognitive complaints is likely to hinder treatment of underlying disease and comorbid conditions, and may present safety issues for the patient and others.” Tools for cognitive assessment in nursing homes “Many people who are developing dementia or already have it do not receive a diagnosis,” according to the National Institute on Aging. It is important to invest the time and expertise to evaluate newly admitted residents. ![]() ![]() Ongoing, standardized assessments help practitioners identify changes over time as well. Establishing an accurate picture of a resident’s cognitive functioning, along with a comprehensive neurobehavioral assessment, can develop a treatment plan and improve quality of life. Cognitive assessment is a paramount need in nursing homes.
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