Handbook of Assessment in Clinical Gerontology, Second Edition

Cover Page\r......Page 1
Handbook of Assessmentin Clinical Gerontology......Page 2
Copyright\r......Page 3
List of Contributors......Page 4
Introduction......Page 8
EPIDEMIOLOGY OF LATE-LIFE DEPRESSION......Page 15
CONCEPTUAL APPROACHES TO ASSESSMENT......Page 16
DEFINITION AND DIAGNOSTIC ISSUES......Page 17
Multicultural Issues......Page 18
Self-Report......Page 20
Direct Observation......Page 21
Assessment of Physical Health......Page 22
Assessment of Cognitive Functioning......Page 23
Self-Report Instruments......Page 24
Beck Depression Inventory......Page 25
Geriatric Depression Scale......Page 26
Hospital Anxiety and Depression Scale......Page 28
Hamilton Rating Scale for Depression......Page 29
Geriatric Depression Rating Scale......Page 30
Measures of Depression with Coexistent Dementia......Page 31
EPIDEMIOLOGY OF BEREAVEMENT......Page 32
Normal Bereavement......Page 33
Factors That Affect Grief Response......Page 34
Complicated Grief......Page 35
Multicultural Issues......Page 36
The Grief Experience Inventory......Page 37
Inventory of complicated grief......Page 38
CONCLUSION......Page 40
APPENDIX A: GERIATRIC DEPRESSION SCALE (GDS)......Page 41
APPENDIX B: INVENTORY OF COMPLICATED GRIEF (ICG)......Page 42
References......Page 43
EPIDEMIOLOGICAL CONSIDERATIONS......Page 56
SPECIAL CONSIDERATIONS......Page 57
Diagnostic Assessment......Page 58
Geriatric Anxiety Inventory (GAI)......Page 60
Panic Disorder and Agoraphobia......Page 61
Alzheimer\'s Disease (AD)......Page 62
Description......Page 63
MULTICULTURAL ISSUES IN ANXIETY ASSESSMENT IN THE ELDERLY......Page 64
Case Study 2dObsessive Compulsive Disorder Treatment andBasal Ganglia Infarct......Page 65
Case Study 4dPost-Traumatic Stress Disorder......Page 66
References......Page 67
CHAPTER 15 Assessment of Agitation innbspOlder Adults\r......Page 72
RESEARCH AND PSYCHOTHERAPY......Page 73
WHY ASSESS BASELINE FUNCTIONING AND OUTCOMES?......Page 74
PSYCHOTHERAPY MEASURES......Page 77
A MODEL OF OLDER ADULTS IN PSYCHOTHERAPY......Page 81
CAREGIVERS......Page 82
TESTING IN DIFFERENT SETTINGS......Page 84
CULTURAL DIVERSITY AND ASSESSMENT......Page 85
CONCLUSION......Page 92
APPENDIX A: SELF-CONTROL QUESTIONNAIRE......Page 93
SCQD Scoring......Page 94
SHORT FORM HEALTH SURVEY (SF-36)......Page 95
UNIVERSITY OF RHODE ISLAND CHANGE ASSESSMENT......Page 97
BASIS-32 (BEHAVIOR AND SYMPTOM IDENTIFICATION SCALE)......Page 98
Instructions......Page 99
Lifestyle, Environmental Factors, and Sleep......Page 102
References......Page 106
INTRODUCTION......Page 646
OVERVIEW......Page 112
DEFINITIONAL ISSUES......Page 113
EPIDEMIOLOGY OF PERSONALITY DISORDERS......Page 114
STABILITY AND CHANGE......Page 116
PSYCHOMETRIC CONCERNS IN LATER LIFE......Page 117
APPROACHES TO ASSESSMENT OF PERSONALITY DISORDERS......Page 118
Decision-Making Involvement of Individuals with Dementia......Page 120
Informant-Report......Page 121
Later-Life Assessment Issues......Page 122
Dementia-Related Issues......Page 123
Multicultural Issues......Page 124
APPENDIX A: MULTI-SOURCE ASSESSMENT OF PERSONALITYPATHOLOGY (MAPP)......Page 125
References......Page 129
CHAPTER 22 Assessment of Capacity\r......Page 339
GENERAL ASSESSMENT CONSIDERATIONS......Page 134
Definition, Prevalence and Course......Page 136
Psychopathologic Symptoms......Page 138
Social Factors......Page 139
Medication Side Effects and Adherence......Page 140
Definition, Prevalence and Course......Page 141
Definition, Prevalence, and Course......Page 142
Assessment Procedures......Page 144
When to Refer to a Sleep Disorders Center......Page 146
POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS)......Page 147
References......Page 162
DESCRIPTION OF COGNITIVE DOMAINS......Page 166
Do Families Know Their Relative\'s Personal and Care Preferences?......Page 167
Mild Cognitive Impairment......Page 168
The Assessment of Driving-Related Skills (ADReS)......Page 170
Vascular Dementia......Page 171
Mattis Dementia Rating Scale......Page 172
Parkinson’s Dementia......Page 173
Normal Pressure Hydrocephalus......Page 174
STANDARD USES AND GOALS OF ASSESSMENT......Page 175
Clinical Dementia Rating Scale (CDR)......Page 176
Visual Analog Scales (VAS)......Page 178
Alzheimer’s Disease Assessment Scale (ADAS)......Page 180
Parameters for Licensure by the Bureau of Motor Vehicles......Page 181
Other Agents......Page 184
Clinical Guidance......Page 185
CONCLUSION......Page 186
References......Page 187
HISTORY OF DELIRIUM AS A CLINICAL CONCEPT......Page 190
General Medical Inpatient and Acute Geriatric......Page 191
Treatment Planning......Page 192
ETIOLOGY/RISK FACTORS......Page 193
The Concepts ``Person-Environment Fit\'\' and ``Aging in Place\'\'......Page 194
Neuropsychological Test Findings......Page 195
THE IMPORTANCE OF ASSESSING DELIRIUM......Page 196
DIAGNOSTIC CRITERIA......Page 197
Cognitive Test for Delirium......Page 199
Pain Coping......Page 200
Delirium Index......Page 201
Delirium Observation Screening Scale......Page 202
The Delirium Rating Scale-Revised-98......Page 203
Delirium Symptom Interview......Page 204
Treatment Model for Agitation and its Implications for Assessment......Page 205
Memorial Delirium Assessment Scale......Page 206
NEECHAM Confusion Scale......Page 207
CASE STUDIES......Page 209
PSYCHOSOCIAL INTERVENTIONS......Page 210
CONCLUSION......Page 211
APPENDIX A: MEMORIAL DELIRIUM ASSESSMENT SCALE (MDAS)......Page 212
REFERENCES......Page 215
CHAPTER 21 Assessing the Personal Preferences of Persons with Dementia\r......Page 222
Memory Assessments......Page 223
Other Cognitive Assessments......Page 225
DIAGNOSTIC ISSUES......Page 226
COGNITIVE TRAINING PROGRAMS AND INTERVENTIONS......Page 227
Mnemonic Strategy Training......Page 228
Procedural Memory Training......Page 229
Interview With the Bed Partner and Family......Page 230
USE OF REASSESSMENT IN CLINICAL WORK......Page 231
CLINICAL CASE STUDY......Page 232
References......Page 233
INTRODUCTION AND HISTORY......Page 240
DEFINITIONS AND SCOPE OF THE PROBLEM......Page 241
CLINICAL SEQUELAE OF ELDER ABUSE AND NEGLECT......Page 242
SCREENING FOR ELDER ABUSE......Page 245
Review of Existing Screening Tools and Assessment Methods......Page 246
SPECIAL ISSUES......Page 247
CONCLUSION AND FUTURE DIRECTIONS......Page 248
APPENDIX A......Page 249
APPENDIX B......Page 250
ELDER ABUSE SCREENING TEST......Page 251
References......Page 252
CHAPTER 18 Geriatric Neuropsychological Assessment\r......Page 254
BACKGROUND ON ASSESSMENT......Page 255
First Steps: The Core Assessment Battery......Page 256
The Roles of the Health Care Professional......Page 260
Behavioral Challenges for Caregivers......Page 261
Positive Rewards of Caregiving......Page 262
The Family Unit......Page 264
THE PRACTICE OF ASSESSMENT......Page 265
Cultural/Racial Issues in Assessment......Page 266
CASE STUDIES......Page 267
APPENDIX B: CAREGIVER ASSESSMENT OF FUNCTION AND UPSET (CAFU)......Page 271
APPENDIX C: POSITIVE ASPECTS OF CAREGIVING......Page 277
References......Page 278
RATIONALE FOR A CHAPTER ON FAMILY ASSESSMENT......Page 283
DIVERSITY IN LATE-LIFE FAMILIES......Page 285
OTHER RELEVANT DEMOGRAPHIC AND SOCIAL TRENDS......Page 286
What is the Purpose of the Assessment?......Page 287
What Should be Told to the Participants?......Page 288
How will Assessment Information from Multiple People be Combined andIntegrated?......Page 289
Summary of Screening Instruments......Page 290
Pain and Function......Page 291
Family Contact and Support......Page 292
Beliefs About Medicines Questionnaire......Page 293
Short Story, Depth Perception, and Color Intensity......Page 294
Family Assessment Measure......Page 295
Family Environment Scale......Page 300
Family APGAR......Page 301
Paternalism and Respect for Autonomy......Page 302
Preferences for Everyday Living Inventory......Page 303
Background Information......Page 304
Case Analysis and Summary......Page 305
INSTRUCTIONS:......Page 307
APPENDIX B:CHECKLIST OF FAMILY RELATIONAL ABILITIES......Page 310
REFERENCES......Page 311
CHAPTER 23 Household and Neighborhood Safety, Mobility\r......Page 315
Medication Misuse......Page 316
Correlates of Prescription Drug Abuse in Older Adults......Page 317
Geriatric Nutritional Risk Index (GNRI)......Page 375
DEFINITIONS OF SUBSTANCE USE RISK IN OLDER ADULTHOOD......Page 318
Problem Use......Page 320
Alcohol......Page 321
Medications......Page 327
BROAD-BASED ASSESSMENT OF ALCOHOL PROBLEMSIN OLDER ADULTS......Page 328
Problems with DSM-IV Criteria for Older Adults......Page 329
Assessing Functional Health......Page 331
Assessing Psychiatric Comorbidity......Page 332
Functional Elements......Page 333
REFERENCES......Page 334
WOMEN, AGING, AND FACTORS AFFECTING SEXUAL FUNCTIONING......Page 340
Physiological Factors......Page 341
Decisional Versus Executional Capacity......Page 342
The AAA Roadwise Review......Page 683
RECENT ADVANCES IN PHARMACOTHERAPY FOR SEXUAL DISORDERS......Page 344
DIVERSITY AND MULTICULTURAL CONSIDERATIONS IN OLDER ADULTS......Page 345
INITIAL STAGES OF ASSESSMENT......Page 348
Assessment of Sexual Consent Capacity in Older Adults......Page 349
Legal and Ethical Standards......Page 350
Assessment Standards and Considerations......Page 351
ASSESSMENT TOOLS AND GUIDELINES......Page 352
A Semi-Structured Interview for Thorough Assessment of Sexual Dysfunction......Page 353
Sexual Beliefs and Information Questionnaire (SBIQ-R)......Page 356
Muscle Tone......Page 689
References......Page 360
PHYSIOLOGICAL CHANGES ASSOCIATED WITH AGING......Page 365
NUTRITION RECOMMENDATIONS FOR OLDER AMERICANS......Page 368
The Anthropometric Measures, Biochemical Data, Clinical Assessment, Dietary Data and Economic Assessment (the ABCDEs)......Page 370
The Mini Nutritional Assessment (MNAreg)......Page 372
The Impact of Medications on Sleep......Page 415
AGING AND CHRONIC DISEASE STATES......Page 377
Hypertension......Page 378
Pulmonary Diseases......Page 379
Cancer......Page 380
DIVERSITY ISSUES THAT IMPACT THE NUTRITION STATUS......Page 381
Living Arrangement......Page 384
REFERENCES......Page 385
INTRODUCTION......Page 389
Subtypes of Problem Behaviors......Page 390
Informant Rating Methods......Page 391
The Purpose of the Chapter......Page 620
Values and Preferences Scale (VPS)......Page 395
Mechanical Devices......Page 396
Comparing Methods of Assessment......Page 397
Woodcock-Johnson Tests of Cognitive Ability (WJ III COG; Woodcock, McGrew, & Mather, 2001b)......Page 401
Staff Communication......Page 402
Abilities Assessment......Page 403
Treatment Continuation Evaluation-Case Studies......Page 404
Means to Enhance Capacity......Page 405
SUMMARY......Page 406
References......Page 407
THE STRUCTURE OF SLEEP FOR OLDER ADULTS......Page 412
Illness and Sleep......Page 414
Psychological and Psychiatric Factors and Sleep......Page 416
SLEEP ASSESSMENT: MEASURES, METHODS, AND STRATEGY......Page 417
The Sleep Assessment Interview......Page 418
Sleep Diaries......Page 419
Test selection......Page 420
Capacity Assessment Handbooks......Page 588
Epworth Sleepiness Scale......Page 423
Wechsler Memory Scale-IV (WMS-IV; Wechsler, 2009)......Page 424
Sleep Hygiene Index......Page 428
References......Page 429
RATES OF TREATMENT ADHERENCE......Page 433
Cognitive Functioning......Page 434
Health Literacy and Numeracy......Page 435
Cultural Factors......Page 437
Evaluation of Functional Capabilities......Page 537
Personality/Psychopathology......Page 442
Serious Mental Illness......Page 444
Morisky Scales......Page 445
Illness Perception Questionnaire......Page 446
Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008)......Page 474
Assessing Stages of Change in Relation to Adherence......Page 447
Ecological Momentary Assessment (EMA)......Page 448
Fuld Object Memory Evaluation (FOME; Fuld, 1981; Fuld, Maser, Blau, Crystal, & Aronson, 1990)......Page 480
Drug Regimen Unassisted Grading Scale......Page 449
Hopkins Medication Schedule......Page 450
Medication Management Instrument for Deficiencies in the Elderly......Page 451
Accelerometers......Page 452
Issues of Limits in Test Data and Test Time......Page 453
Availability of Health Care......Page 454
Shared Decision-Making in Treatment Planning......Page 455
References......Page 456
Dementia Evaluation......Page 464
Outcome Monitoring......Page 466
Medication Use......Page 467
Physical, Sensory, and Cognitive Limitations......Page 468
Clinical Considerations......Page 469
Capacity as Defined in Health Care Consent Law......Page 584
Normative Data for the Oldest Old......Page 471
CLINICAL CONSIDERATIONS IN ASSESSING THE OLDER ADULT......Page 472
Description......Page 473
Kaufman Adolescent and Adult Intelligence Test (KAIT; Kaufman & Kaufman, 1993, 1997)......Page 475
Memory Assessment Measures......Page 477
Rey Auditory Verbal Learning Test (AVLT; Rey, 1958)......Page 479
Measures of Executive Functioning......Page 481
Delis-Kaplan Executive Functioning System (D-KEFS; Delis, Kaplan, & Kramer, 2001)......Page 482
Assessment of Depression and Anxiety......Page 483
Computer-Based Testing......Page 484
Multicultural Neuropsychology......Page 487
Report Writing......Page 488
Serial Testing......Page 489
SUMMARY......Page 491
INTRODUCTION......Page 505
SCREENING FOR DEMENTIAdTHE LEGACY OF THE MMSE......Page 507
Mini-Cog......Page 509
Pain Severity......Page 510
Are IWDs Able to Provide Reliable and Valid Responses?......Page 563
Seven-Minute Screen......Page 511
Montreal Cognitive Assessment (MoCA)......Page 512
Clock Drawing Tests......Page 513
Consortium to Establish a Registry for Alzheimer\'s Disease (CERAD) Battery......Page 514
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)......Page 515
Mattis Dementia Rating Scale and Fuld Object Memory Evaluation......Page 517
Fuld Object Memory Evaluation......Page 518
Intra-individual variability on cognitive measures......Page 519
Technology and Screening......Page 520
REFERENCES......Page 525
PROBLEMS IN ASSESSING COGNITION IN LATE STAGE DEMENTIA......Page 533
Defining Late Stage Dementia......Page 534
Approaches to Cognitive Assessment in Late Stage Dementia......Page 535
Defining Stages of Dementia Severity......Page 536
Multicultural Issues in Functional Capacity......Page 538
Summary of Assessment Issues in Advanced Dementia......Page 540
MEETING THE CHALLENGE: INTERVENTION MODELS......Page 541
PHYSICAL ASSESSMENT......Page 687
The Healthcare Triangle......Page 542
Use of Montessori Activities for Persons with Dementia......Page 544
Montessori-Based Activities Used for Cognitive Assessment in Dementia......Page 545
Hand Washing......Page 546
Land/Water Sorting......Page 547
Fine Motor Skills and Color Matching......Page 548
How the MAS is Administered......Page 549
An Example of Using the MAS......Page 550
The MAS and Sensory Deficits......Page 551
SUMMARY AND CONCLUSIONS......Page 552
REFERENCES......Page 554
INTRODUCTION......Page 558
INCIDENCE OF DEMENTIA AND OTHER COGNITIVE IMPAIRING CONDITIONS......Page 559
EARLY DIAGNOSIS OF DEMENTIA: CHALLENGES AND OPPORTUNITIES......Page 560
UNDERSTANDING PREFERENCES AND DECISION MAKINGFOR EARLY-STAGE FAMILIES......Page 561
Practice Implications for IWDs, Families, and Providers......Page 564
INSTRUMENTS THAT ASSESS PERSONAL PREFERENCESAND DESIRES......Page 565
Preferences for Everyday Living Inventory (PELI)......Page 567
Decision-Making Involvement Scale (DMI)......Page 568
DO PREFERENCES FOR CARE VARY ACROSS DIFFERENT POPULATIONS?......Page 569
ENHANCING DECISION-MAKING AND UNDERSTANDING OF PERSONALPREFERENCES IN DEMENTIA......Page 570
Self-Awareness of Cognitive Losses and Skills......Page 571
REASSESSMENT OF CARE VALUES AND PREFERENCES AND A LOOK TO THEFUTURE......Page 572
ACKNOWLEDGMENTS......Page 573
American Geriatrics Society (AGS)......Page 574
APPENDIX B: PREFERENCES FOR CARE TASKS (PCT) WORKSHEET &MAGNET BOARD LAYOUT......Page 575
References......Page 576
Clinical Capacity......Page 580
Actions That Follow Clinical Findings of Incapacity......Page 581
Capacity as Defined in Guardianship Law......Page 582
Capacity to Appoint a Durable Power of Attorney......Page 585
Problems with Clinical Assessment of Capacity......Page 586
Legal Standard......Page 589
Values and Preferences......Page 590
Clinical Judgment......Page 591
A PROCESS FOR CAPACITY ASSESSMENT......Page 592
Issues in Informed Consent......Page 593
FUTURE DIRECTIONS......Page 602
Questions to add to a clinical interview for financial capacity evaluation......Page 604
APPENDIX B: INTERVENTIONS TO ADDRESS DIMINISHED CAPACITY......Page 605
APPENDIX C: CAPACITY ASSESSMENT TOOLS......Page 609
APPENDIX D: CAPACITY WORKSHEET FOR PSYCHOLOGISTS......Page 610
REFERENCES......Page 614
Pain Sensation......Page 618
Definitions......Page 621
The Berg Balance Scale (BBS)......Page 622
Description......Page 624
Description......Page 625
Description......Page 626
Description......Page 627
Individual FAB Items......Page 628
HOME SAFETY ASSESSMENTS......Page 629
Description......Page 630
Description......Page 631
Memory Assessments......Page 636
The Limitations of Existing Home Safety Measures......Page 637
NEIGHBORHOOD SAFETY AND MOBILITY ASSESSMENTS......Page 639
CRAIG Hospital Inventory of Environmental Factors (CHIEF and CHIEF-SF)......Page 640
Scoring Instructions for the NES......Page 641
REFERENCES......Page 642
NEUROCOGNITION AND NOCICEPTION......Page 647
THE PAIN EXPERIENCE......Page 648
Pain and Depression......Page 651
Driving Decisions Workbook......Page 682
Efficacy Expectancy Beliefs......Page 653
Self-Report Measures......Page 657
Observational measures......Page 658
Performance Measures......Page 660
CLINICAL PRACTICE GUIDELINES......Page 661
American Medical Directors Association (AMDA)......Page 662
CONCLUDING REMARKS......Page 663
APPENDIX A: PAIN SELF-EFFICACY QUESTIONNAIRE (PSEQ)*......Page 664
APPENDIX B: PAIN CATASTROPHIZING SCALE*......Page 665
APPENDIX C: PAIN DISABILITY INDEX*......Page 667
REFERENCES......Page 668
OLDER DRIVERS AS A GROUP......Page 677
Driving: A Rite (of Passage) or a Right?......Page 678
SELF-ASSESSMENTS THAT CAN HELP TO SCREEN DRIVER READINESS......Page 679
CLINICAL-BASED SCREENING TOOLS FOR DRIVING FITNESS......Page 684
THE DRIVER REHABILITATION CLINICAL EVALUATION......Page 685
Range of Motion and Strength......Page 688
Reaction Speed......Page 690
Balance......Page 691
THE ROLE OF VISION IN THE OPERATION OF A MOTOR VEHICLE......Page 692
Visual Skills......Page 693
Attention......Page 695
Memory......Page 696
Visuospatial Functioning and Visuomotor Functioning......Page 697
The Role of Executive Functioning in Driving......Page 698
Visual Perception Tests......Page 699
DRIVING KNOWLEDGE......Page 700
Coordination With the On-Road Evaluation......Page 701
APPENDIX A: ASSESSMENTS THAT COMPRISE THE DRIVERREHABILITATION CLINICAL ASSESSMENT......Page 702
AdministrationdPart A......Page 704
Administration-Part B......Page 705
APPENDIX C: GUIDELINES FOR MOTOR VEHICLE ADMINISTRATORS:LICENSE RENEWAL REQUIREMENTS......Page 706
APPENDIX D: STATE OF MICHIGAN’S DRIVER LICENSING REQUIREMENTSAND REPORTING LAWS......Page 713
APPENDIX E: LICENSING REQUIREMENTS......Page 714
REFERENCES......Page 715
Index......Page 719