Cognitive and Intellectual Abilities Assess orientation to time, person and place Assess memory (recent & remote) o Immediate – ask pt to repeat a series of numbers or a list of objects o Recent – ask pt to recall recent events, such as that days visitors or the purpose of the current mental health appointment or admission o Remote – ask the pt to state a fact from their past that is verifiable (DOB or mother’s maiden name) Assess level of knowledge Assess ability to calculate Assess ability to think abstractly (such as interpreting cliché) Perform an objective assessment of the pts perception of their illness Assess judgement based on their answer to a hypothetical question Assess rate and volume of speech, and quality of language (speech should be articulate and responses meaningful and appropriate) Standardized Screening Tools Mini-mental State Examination (MMSE) – used to objectively assess a pts cognitive status by evaluating: Orientation to time and place Attention span and ability to calculate by counting backward by 7 Registration and recalling objects Language – names of objects, following of commands and ability to write Glasgow Coma Scale – used to obtain a baseline assessment of a pts LOC and for ongoing assessment Eye, verbal and motor response evaluated Highest value: 15 – awake and responding appropriately 7 or less – coma Considerations Across the Lifespan Children and Adolescents
Assessment includes temperament, social and environmental factors, cultural and religious concerns and developmental level o Mentally healthy children/adolescents trust others, view the world as safe, accurately interpret their environment, master developmental tasks and use appropriate coping skill Experience some of the same mental health problems as adults Not always easily diagnosed due to: o Lack of the ability/ necessary skills to describe what is happening o Wide variation of “normal” behavior Standardized Assessment Tool: HEADSSS to evaluate adolescents o H ome environment – pts relationship with parents and other members living in the home o E ducation/employment – is the pt employed? School performance o A ctivities – sports? Other activities? Interaction with peers o D rug and Substance use – substances such as ETOH, tobacco or marijuana o S uicide/depression – pt at risk for suicide or self injury? Indications of depression? o S avagery – exposed to abuse in the home or violence in neighborhood Older Adults Assessment should also include: o Functional ability (perform ADLs), economic and social status, and environmental factors that can affect the pts well-being and lifestyle o Physical assessment Standardized assessment tools o Geriatric Depression Scale (short form) o Michigan alcoholism screening test: geriatric Version o MMSE o Pain Assessments: visual analog scales, Wong-Baker FACES Pain Rating Scale, the Faces
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