This article is a transcribed edited summary of a video Bob and Brad recorded in December of 2020. For the original video go to https://www.youtube.com/watch?v=MuvbGXyUr0U&t=45s
Bob: Today, our title is "Is a loved one developing dementia?" So we have three tests you can do to find out. And these are pretty well tested tests.
Brad: Yeah, they’ve been around for years. Years.
Bob: So Brad and I, in our practice, always would also work in nursing homes. We were seeing outpatients, but we were also seeing patients that come into a nursing home and they're doing rehab hopefully to go home.
Bob: Some of the tests done by our occupational therapists was to determine whether or not they had the cognitive power to be at home.
Bob: You know, are they going to make right decisions.
Brad: Can they figure their checkbook, can they answer the phone, and have effective conversations.
Bob: Using the stove. Can they handle their medicine? Or can they organize their medicine, or do they need to have someone come in and do that for them? So all these things are very important. So I've been hearing these tests be done for years. Like you hear them in the background. And sometimes I think, "Boy, I don't know if I'd pass that test," but, there's three tests that are commonly used by our occupational therapists that actually are available for free. I got the website. It's www.myotspot.com, the links are below too.
Brad: You'll see it down there. You can type it all in and get you there.
Bob: Yeah, and they actually have five tests. And again, you can print it out. The one has instructions on how to use it. The reason I did this is because my mom, she's 90 years old, and she's doing pretty well. She's living in independent living yet, but a couple of my sisters were thinking, "Well, does she need to be in assisted living?" So, I did the test on her. I did the Short Blessed Test. I don't know where that comes, Blessed.
Brad: Yeah, well, it's a good test by Bob, obviously.
Bob: Yeah, it is a good test. Again, I've heard it being mentioned by OTs for years. And I did it to her. She passed with flying colors, Brad.
Bob: I was really happy. I didn't think she would.
Brad: But you didn't do it to yourself.
Bob: I did not do it to myself. LOL. My mom only has an eighth-grade education, both my mom and dad. But she's a smart lady. She is no dummy.
Brad: Right. Well, you can self-educate quite well.
Bob: Right, right, so we're going to mention the three tests and give just a few questions from there. So you can kind of get a sense of what it's like. So do you want to start with the Short Blessed?
Brad: Sure. The first one, I think, they start out easier and get more difficult. It's, "What year is it now?" And the person responds. And you circle "correct" or "incorrect." Number two, what month is it now? So little more detailed. Now this one here.
Bob: This is the tough one. This is the one my mom had trouble with. She got most of it, but at the end it was harder.
Brad: You'll see. Please repeat this name and address after me, as you speak to the person being tested. John Brown, 42 Market Street, Chicago.
Bob: And they're supposed to repeat it. And then you say it again, John Brown, 42 Market Street, Chicago. They repeat it again, and then you have them repeat it one more time, and now we tell them to remember that name and address for a few minutes. And again, We hear occupational therapists saying this all the time, and then at the end, you know, after you've been distracted, they ask you the name again. And my mom got most of it, but she she missed the 42, which is all right. All right. How about one last one? This is the one I was proud of my mom that she got. Say the months of the year in reverse order. So, December, November, October..... Yeah, you got to think a little bit on that one. All right, so that's the Short Blessed Test. I don't know where that name came from. And then this name, all these names, you get a kick out of them.
Brad: The nice thing about these tests is they give you information through each question. And as the tester, if you have a question, maybe you don't understand it, it gives you a little explanation on how to do it.
Bob: It does on the Short Blessed Test. It doesn't on these others, but I don't think you need it on these.
Bob: So that's nice, and then for scoring. So it's very complete. So you don't have go to a class to take those. Just take your time with it, go through it, and you'll be able to do it with your loved one or whoever.
Bob: Yeah, yeah. Check it out. See if they're they're safe at all. I mean, like on the Blessed, if you're... Let's see what the final results are here. If you have normal cognition, you're zero to four. My mom was right on that four. If you have questionable impairment, you're five to nine. And so you still might be able to be at home.
Bob: And if you have 10 or more, then it's consistent with dementia.
Brad: I did this with my mother with some balance testing. Take this, put the date on it and file it. Have some copies, so maybe in a year you can retest the person and see if there's changes.
Bob: Also, if they do test fairly high, meaning possible for dementia, then you would go to the doctor and have it assessed, too.
Brad: Yeah, have a professional do it.
Bob: Next one's called the SLUMS Examination.
Brad: Must be an acronym. Yeah. It's all capital letters.
Bob: You want to give a couple of questions from there, Brad?
Brad: Sure. Again, the first ones start out easy. "What day of the week is it?" Number two, "What is the year?" Number three, "What state are we in?" Do you want to go to the more difficult ones?
Bob: Number four, I think that's a fairly tough one. It says, "Please remember these five objects: Apple, pen, tie, house, car." I'd have to visualize them and put them together, otherwise... You know, that's a tough one. The other one I thought was kind of tough is "Please name as many animals as you can in a minute." I mean, I don't know. I'm just not good on the spot like that.
Brad: Yeah, especially if the person's a little nervous, they know being tested, that changes things.
Bob: Yeah, it does.
Brad: I like this part of the test. There's a round circle and then you're supposed to draw the face of a clock on there. And so that's some cognitive things as well as some spacial things, right to left side, which as a therapist, you understand neurologically that can tell you some problems, particularly if they're possibly had a stroke, a mini stroke, and you can talk just fine. But when you draw the clock on there and they only do half the clock, and it's really amazing that the person seems normal talking, but they can't do the clock test.
Bob: Right, it's been interesting seeing some of those results. And I have seen some of those, but they ask you to put an actual time on there, 10minutes to 11.
Brad: Oh, sure.
Bob: And then they have a story they tell you, and you have to remember details of that. I thought that's pretty hard, too, Brad. They do score this, if you have a high school education They have a different set of scores for if you have less than a high school education, so you do have a little more leeway there.
Brad: So that one has a total of 11 questions. You know, the whole thing is going to take you, I would imagine 10 or 15 minutes if you take your time.
Bob: Yeah, the Blessed took about 10 minutes.
Brad: Yeah, I would suggest that, you know, go through these, maybe go through it with a family member so you feel comfortable with it. So you don't fumble around, because that can make someone nervous as well.
Bob: Yeah. The final one is called the Mini Mental State Examination, MMSE. I looked at that one, for some reason I didn't like it.
Brad: Well that one, I know the social workers that I've worked with use this one.
Bob: Oh, do they?
Brad: It's quicker.
Bob: Yeah, and it's not just occupational therapists on this one, you're right.
Brad: I think it's more general. The other ones get a little more detailed on memory and maybe some other neurological aspects.
Bob: You're supposed to count backwards from 100 by 7s. I thought my mom would really have trouble with that one, but again, it might be the one that you think you could use, and it might be appropriate for your person. Maybe the person was an accountant, and that'd be a good question for them.
Brad: Sure, sure. And the recall language aspect is on there.
Bob: Yep. So check them out. They're all free, and you can give them a try, and we don't think you need any training to provide them. Maybe people are going to be mad at us, the OTs, for saying that. But I was able to do it, and I'm not that smart. So there we go. Remember Brad and I can fix just about anything...
Brad: Except for...
Bob: A broken heart.
Brad: That's right.
Bob: But we'll work on it.
Dementia Test Website Link: www.myotspot.com/cognitive-assessments-for-occupational-therapists
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