Estate Planning

A New Approach to Screening for Cognitive Impairment

By Hull and Hull LLP

Cognitive impairment is not always readily apparent.  When a patient sees a doctor for an ailment of a non-cognitive nature, there is no certainty that the doctor will spend sufficient time with the patient to detect the need for a capacity assessment.  Indeed, the evidentiary value of medical records in estate or capacity litigation may be considerably limited when the focus of the treating physician is not the brain.  Moreover, if a visit is for a limited period of time, there simply may not be sufficient time for any meaningful assessment of capacity even if there were an issue.

A new screening test that takes just two minutes could detect as many as eight in ten cases of cognitive impairment, according to an article in the Archives of Internal Medicine. Current screening tests take a minimum of 10 to 15 minutes, and require the patient to write with pen and paper. Not only is this a problem for people who are hospitalized but it is greatly dependent upon the patient's degree of literacy in the English language.

The 'Sweet Sixteen,' (as it is known) is a product of Harvard Medical School that involves 16 elements including questions on basic orientation, items to remember, and counting sequences forwards and backwards.  Although similar to the MMSE, or Mini-Mental State Examination, it takes less time and is apparently just as effective at finding mild cognitive problems.

Interestingly, payment for annual cognitive screening of all Medicare patients is a provision of The Patient Protection and Affordable Care Act which President Obama signed into law last year.
 

David Morgan Smith

Full post as published by Toronto Estate Law Blog on November 11, 2010 (boomark / email).