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  • Karen McPhail, RN, MSN

The True Importance of Adjusting Cognitive Evaluation Techniques for Those With Visual and Hearing I

In follow up to today's blog entry as requested by several readers...

Often times facilities take a cookie cutter approach to cognitive evaluations for seniors. However, everyone is different and many factors need to be considered in order to obtain an accurate assessment of cognition. I find that clients with visual and hearings impairments are often times evaluated poorly due to this broad approach. Research shows that commonly used cognitive screening tests are often vision and hearing -dependent which limits their validity for impaired individuals! For example, the MMSE is often used at facilities to assess residents. This test has three items relying entirely on vision which are the reading, writing, overlapping pentagon copying tasks. In addition, many of the question rely upon proper hearing so this adds an additional challenge for many and even more skewed results. So sadly residents who cannot complete these items automatically get a lower score on the exam when assessed. They are basically disadvantaged from the start due to their disabilities! Sadly in facilities this leads to many issues and the misplacement of residents in memory care. Visually and hearing impaired individuals simply cannot be evaluated with traditional cognitive exams. The broad, one size fits all approach to cognitive evaluations needs to end!

The reality is stated clearly in the article, Screening tools for the identification of dementia for adults with age-related acquired hearing or vision impairment: a scoping review by Annie Pye (a1), Anna Pavlina Charalambous (a2), Iracema Leroi (a1) (a3), Chrysoulla Thodi (a2) ..., Published online: 10 July 2017:

"While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established."

Below are some additional references on the importance of modifying cognitive evaluation techniques for those with visual and hearing impairments. Ensure that you understand the process and that alternative methods are used to assess and guide you or your loved one correctly. If you need assistance with this or advocacy in this area please reach out as I am always happy to help!


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