Tracking Functional Status
There is ample research in the field of geriatrics and dementia which has produced accredited studies detailing measurable outcomes from assessment tools designed to quantify characteristics of persons suffering from dementia in the areas of depression, cognition, nutrition, behaviour and even happiness. Using these tools to create baseline assessment and measure changes in condition will enable providers, families and primary care professionals to measure and understand the disease progression and determine the best course of treatment for these residents that will enable them to achieve the highest possible functional status and quality of life.
Assessment Tools:
· The Mini–Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. It is commonly used inmedicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment.
· The Geriatric Depression Scale (GDS) is a 30-item self-report assessment used to identify depression in the elderly. In the Geriatric Depression Scale, questions are answered "yes" or "no." A five-category response set is not utilized in order to ensure that the scale is simple enough to be used when testing ill or moderately cognitively impaired individuals, for whom a more complex set of answers may be confusing, or lead to inaccurate recording of responses.
https://geriatrictoolkit.missouri.edu/cog/GDS_SHORT_FORM.PDF
· The Cornell Scale for Depression in Dementia (CSDD) is a way to screen for symptoms of depression in someone who has dementia. Unlike other scales and screens for depression, the CSDD takes into account additional signs of depression that might not be clearly verbalized by a person. For example, if your loved one or patient has Alzheimer's disease, vascular dementia or other kind of cognitive impairment, he might not consistently be able to accurately express his feelings. The Cornell Scale measures observations and physical signs that could indicate depression.
· The Morse Fall Scale (MFS) is a rapid and simple method of assessing a patient’s likelihood of falling. A large majority of nurses (82.9%) rate the scale as “quick and easy to use,” and 54% estimated that it took less than 3 minutes to rate a patient. It consists of six variables that are quick and easy to score, and it has been shown to have predictive validity and interrater reliability. The MFS is used widely in acute care settings, both in the hospital and long term care inpatient settings. http://networkofcare.org/libraryMorse%20Fall%20Scale.pdf
· The Comprehensive Geriatric Assessment (CGA) - The geriatric assessment is a multidimensional, multidisciplinary assessment designed to evaluate an older person's functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. It is usually initiated when the physician identifies a potential problem. Specific elements of physical health that are evaluated include nutrition, vision, hearing, fecal and urinary continence, and balance. The geriatric assessment aids in the diagnosis of medical conditions; development of treatment and follow-up plans; coordination of management of care; and evaluation of long-term care needs and optimal placement. The geriatric assessment differs from a standard medical evaluation by including nonmedical domains; by emphasizing functional capacity and quality of life; and, often, by incorporating a multidisciplinary team. It usually yields a more complete and relevant list of medical problems, functional problems, and psychosocial issues. https://www.bgs.org.uk/sites/default/files/content/resources/files/2019-02-08/BGS%20Toolkit%20-%20FINAL%20FOR%20WEB_0.pdf
· The Mini Nutritional Assessment - The Mini Nutritional Assessment is an effective, easily administered tool designed to identify older adults who have or are at risk for developing malnutrition. It consists of 18 questions and can be completed in about 15 minutes. A short form, containing the first six questions, can be used for screening. h
· Saint Louis University Mental Status Examination (SLUMS) - a method of screening for Alzheimer's and other kinds of dementia. It was designed as an alternative screening test to the widely used Mini-Mental State Examination (MMSE). The idea was that the MMSE is not as effective at identifying people with very early Alzheimer's symptoms. Sometimes referred to as Mild Cognitive Impairment (MCI) or mild neurocognitive disorder (MNCD), these symptoms occur as people progress from normal aging to early Alzheimer's. h
