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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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We met with her new Memory Care Physician. He evaluated her and gave her the MMSE. I don’t understand how she can score that high yet needs caregivers for EVERYTHING. Has anyone else experienced this?
Hi Gigigrl, My mother also tested very high on her initial cognitive exam when I knew something was seriously wrong. Mom had been primary caregiver for her Mother, Father, and my Dad. She knew all the standard answers for the NC cognitive test by heart. I had to inform her doctor of this before it was agreed to change the standard test questions slightly and retest her. Six months after showing significant decline, we finally had a diagnosis of dementia. Perhaps this is the same situation for your mother. Don't be afraid to ask for a slightly altered test so she can't pop off memorized answers. I hope this helps! Michelle Freeze
I would say it means start learning what you can. I wish I had taken my husband's diagnosis more serious when we were first told he had Parkinson's related mild cognitive decline then later PD related mild dementia. So many things during his progression might not have frustrated me as much if I had opened my eyes a bit wider to better understand why he was acting the way he was. I am just now able to accept and call it dementia when with family/friends... which I am sure they probably called it that among themselves from the beginning.
@Lealonnie1 "A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both."
I have not read the first one yet, but I have "The 36 Hour Day" and agree it is a great resource to use as I have new questions. I also recently got and highly recommend "Dementia Care Companion - The Complete Handbook of Practical Care from Early to Late Stage" written by Mehdi Samadani. I have not read either completely but enough to tell me I need to keep reading as well as having both handy for reference as my husband's dementia progresses.
Information definitely empowers and can help reduce the frustration. Even if it is only a small bit at times, I have found it helpful as a stress reducer.
One thing to be aware of with these tests and the scores, is they are for an "average" person and for those within their age cohort. In other words, a younger person in theory is expected to score higher than someone 15 years older, so the what is mild cognitive v various stages of dementia depends. Also, "the average" part means that someone with advanced degrees, PhD, JD, MD etc. would be expected to shore higher than someone with a high school degree.
All to say, generic numbers for this or that test really depend on the above noted parameters. Talking with the LOs' neurologists or neuropsychologist who likely performed the test is best to have an accurate understanding of what the test numbers mean for your LO. One size (one test score number) does not fit all.
And folks w/dementia can rally; do better one day relative to the next. If they have had the test several times, they may do better as they might be more comfortable with the test.
Finally, mini status (MMSE) and the MoCA tests are fine in terms of a screening, but a full neuro-psych testing battery is IMHO better. More here: https://practicalneurology.com/articles/2016-july-aug/a-primer-in-neuropsychological-assessment-for-dementia
Scoring a 24 on the MMSE indicates mild cognitive impairment/Alzheimer's Disease.
MMSE score, for example, denotes the severity of cognitive impairment as follows: mild Alzheimer's disease: MMSE 21–26, moderate Alzheimer's disease: MMSE 10–20, moderately severe Alzheimer's disease: MMSE 10–14, severe Alzheimer's disease: MMSE less than 10.
Some of your mother's behavior of needing help with everything could be learned helplessness. Maybe she enjoys the attention and help? When my mother took the MoCA test the first time, she scored an 18 out of 30 which also indicates mild cognitive impairment (the tests are scored differently). Meanwhile, she was introducing me, her daughter, as her MOTHER to people I'd known for years. She was also incontinent at that time. So, dementia presents itself differently. The old saying goes, if you've met one person with dementia, you've met one person with dementia. And no truer words were ever spoken.
Mom had good days and bad days, yet she could always Showtime like an Academy Award winning actress. She moved into Memory Care Assisted Living at one point, and caregivers were asking WHY she was there! She could make small talk beautifully, but ask her a REAL question and she was lost.
A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both.
Wishing you the best of luck with a difficult situation.
@ Lealonnie 1: "MMSE score, for example, denotes the severity of cognitive impairment as follows: mild Alzheimer's disease: MMSE 21–26, moderate Alzheimer's disease: MMSE 10–20, moderately severe Alzheimer's disease: MMSE 10–14, severe Alzheimer's disease: MMSE less than 10."
None of the simple dementia screening tests can denote Alzheimer's disease. Substitute the word dementia for Alzheimer's and your post is very spot on. There are a wide variety of dementia types that can only be verified by a full neuro-psych evaluation. Several years ago, a neuro-psychologist verified my husband had moderate dementia related to his Parkinson's. We were also told he did not show tendencies like Alzheimer's or Lewy Bodies at that time.... but it did not rule out either from ever becoming his issue. Recently, it has progressed to where I am being told Lewy Bodies are probably forming in his brain. However, his dementia is still not diagnosed as Lewy Body Disease. Our neurologist told me that over time, PD often has Lewy Body symptoms tagging on to it and Lewy Body Disease often has PD symptoms tagging on to it but they are still separate diseases.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My mother also tested very high on her initial cognitive exam when I knew something was seriously wrong. Mom had been primary caregiver for her Mother, Father, and my Dad. She knew all the standard answers for the NC cognitive test by heart. I had to inform her doctor of this before it was agreed to change the standard test questions slightly and retest her. Six months after showing significant decline, we finally had a diagnosis of dementia.
Perhaps this is the same situation for your mother. Don't be afraid to ask for a slightly altered test so she can't pop off memorized answers. I hope this helps!
Michelle Freeze
@Lealonnie1 "A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both."
I have not read the first one yet, but I have "The 36 Hour Day" and agree it is a great resource to use as I have new questions. I also recently got and highly recommend "Dementia Care Companion - The Complete Handbook of Practical Care from Early to Late Stage" written by Mehdi Samadani. I have not read either completely but enough to tell me I need to keep reading as well as having both handy for reference as my husband's dementia progresses.
Information definitely empowers and can help reduce the frustration. Even if it is only a small bit at times, I have found it helpful as a stress reducer.
All to say, generic numbers for this or that test really depend on the above noted parameters. Talking with the LOs' neurologists or neuropsychologist who likely performed the test is best to have an accurate understanding of what the test numbers mean for your LO. One size (one test score number) does not fit all.
And folks w/dementia can rally; do better one day relative to the next. If they have had the test several times, they may do better as they might be more comfortable with the test.
Finally, mini status (MMSE) and the MoCA tests are fine in terms of a screening, but a full neuro-psych testing battery is IMHO better. More here: https://practicalneurology.com/articles/2016-july-aug/a-primer-in-neuropsychological-assessment-for-dementia
Dementia is like cancer, there are so many variables...not One Size Fits All.
A possible case of "learned helplessness?"
MMSE score, for example, denotes the severity of cognitive impairment as follows: mild Alzheimer's disease: MMSE 21–26, moderate Alzheimer's disease: MMSE 10–20, moderately severe Alzheimer's disease: MMSE 10–14, severe Alzheimer's disease: MMSE less than 10.
Some of your mother's behavior of needing help with everything could be learned helplessness. Maybe she enjoys the attention and help? When my mother took the MoCA test the first time, she scored an 18 out of 30 which also indicates mild cognitive impairment (the tests are scored differently). Meanwhile, she was introducing me, her daughter, as her MOTHER to people I'd known for years. She was also incontinent at that time. So, dementia presents itself differently. The old saying goes, if you've met one person with dementia, you've met one person with dementia. And no truer words were ever spoken.
Mom had good days and bad days, yet she could always Showtime like an Academy Award winning actress. She moved into Memory Care Assisted Living at one point, and caregivers were asking WHY she was there! She could make small talk beautifully, but ask her a REAL question and she was lost.
A good book to read is Understanding the Dementia Experience by Jennifer Ghent-Fuller available on Amazon. Or The 36 Hour Day, more of a reference book. I recommend both.
Wishing you the best of luck with a difficult situation.
None of the simple dementia screening tests can denote Alzheimer's disease. Substitute the word dementia for Alzheimer's and your post is very spot on. There are a wide variety of dementia types that can only be verified by a full neuro-psych evaluation. Several years ago, a neuro-psychologist verified my husband had moderate dementia related to his Parkinson's. We were also told he did not show tendencies like Alzheimer's or Lewy Bodies at that time.... but it did not rule out either from ever becoming his issue. Recently, it has progressed to where I am being told Lewy Bodies are probably forming in his brain. However, his dementia is still not diagnosed as Lewy Body Disease. Our neurologist told me that over time, PD often has Lewy Body symptoms tagging on to it and Lewy Body Disease often has PD symptoms tagging on to it but they are still separate diseases.