3.2.5 Recognizing Changes in Mental Status

When conducting an assessment for changes in mental status, it is helpful to know the baseline of the client’s mental status.  If they are diagnosed with dementia, keep questions to current identifiers they may be able to answer at their level of dementia.

If they do not have dementia, work through the following list of questions:

  • Is the client oriented to who they are, where they are and the date, day, time of year etc.?
  • Are they alert to what is going on around them, or do they seem to be disoriented to surroundings?
  • Are they paying attention to you as you speak with them? Are they responding to your attention and questions the same as usual?
  • Is their ability to think at their normal level? Are they taking the same amount of time to respond or is it slower?
  • Is their recent memory intact (for example, what did they eat for the last meal)?
  • Is the speech the same (clear versus slurred)?
  • Are they relaxed or stressed? Are they wringing their hands, rocking, or pacing, or are they sitting in a relaxed manner calmly speaking to you? Is their speech fast or slow, are they looking at you or looking away?
  • Are their activities and interests the same? Are their choices the same as they usually are, or do they want different things to eat/drink than normal (for example, they order macaroni when they never have liked it, tea when they only drink coffee; they are watching mysteries when they usually don’t like them; they change their hair when they always have it one way; or they don’t want to read books when they usually read one a day)?

Record the results of your assessment and report the results to your supervisor.

This video will give a brief demonstration of a mental status assessment:


Click here for a video transcript in .docx format: Video Transcript


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