ACE III Flashcards

Question

what should happen at the pre screening convo

Answer 1

gain informed consent by: saying why you want to administer it possible outcomes what is involved let them know its their choice

Answer 2

language has an impact (like test, poor performance, fail, bad score) setting influences performance make sure they are informed give feedback so as to not feel apprehensive about their performance acknowledge the patients viewpoint more

Answer 3

no one else in the room unless specifically requested (but they cannot give hints) do in a quiet room make sure there are no interruptions positive reassurance therapeutic rapport ask if they want to discontinue if anxious they can stop at any time give them time to answer follow instructions- standardised test so dont invalidate results

Answer 4

Check if the patient wears glasses/hearing aid and if these items are to hand For patients with known literacy difficulties omit the following: Language Comprehension: writing and reading items The ACE-III can be photocopied to A3 size for those with visual difficulties Write down all responses on the record form – correct and incorrect responses Do not score the ACE-III as you are administering it….. this distracts patients if they see scores For ease of administration, instructions to be given to the patient are stated on the record form

Answer 5

Calculating total scores Attention Domain Numbers Item Common Error: Not assigning points for correct subsequent subtractions of 7 following a mistake. The instructions state that 'If subject makes a mistake, do not stop them. Let the subject carry on and check subsequent answers (e.g. 93, 84, 77, 70, 63 – score 4)' Memory Domain Name and Address Recognition Item Common Error: Not assigning points for the items remembered on the name and address recall item previous to this. The instructions for this item specify to '…start by ticking items recalled in the shadowed column on the right hand side'. Language Domain Naming Some patients point to the barrel when asked to point to the picture that has a nautical connection. This should be scored as incorrect. Although it can be argued that a barrel has indeed got a nautical connection, it is not the most likely answer. The test cut-off scores have been devised based on scoring the ACE-III in this way and so we recommend you can score this as incorrectly, yet perhaps ask 'could it be something else' to determine whether they would select the anchor. Even if they point to the anchor following this prompt, this should still be scored 0, but it can be noted that they identified the anchor on prompting for qualitative information Single Word Repition Item Common Error: Assigning points when a word is pronounced incorrectly at first attempt but correctly upon a second attempt. The instructions state that 'Only first attempt is scored' Visuospatial Domain Clock Item Common Error: Not assigning points for partly correct positioning of numbers/hands. Using the scoring guide when scoring performance is essential so you can review examples.

Answer 6

provide positive feedback feedback in future score without patient

Answer 7

Cut-off scores of 88 and 82 out of 100 are recommended for suspicion of dementia. Cut-off scores of 25 and 21 out of 30 are recommended for the M-ACE. Explain to the patient that the test has a cut-off score – (how you would expect of someone of their age to perform) Do not tell the patient what the cut off scores are If a patient scores below 82, inform the patient that their performance was not as high as you would have expected and therefore you would like to refer them for further assessment by a specialist If a patient scores between 88 and 82 you should tell them that they have scored within a 'borderline' range, which means that they have performed slightly below the cut off and as a result you would like to refer them on for further assessment. Whether a patient scores in the ‘borderline’ range or below 82, you should tell the patient, and their significant other (e.g if a relative or friend is in attendance) that there are a range of possible reasons for performing below the cut off and that further assessment would be beneficial, helpful if the patient has a significant other (e.g. relative or friend) present when you are providing feedback You should be familiar with what the next step will be in your health board area. If a patient scores 89 or above you can usually reassure them that they have performed above the cut off.

Answer 8

can still be referred if clinical concerns (like the patient has had a high level of educational or occupational achievement) presenting unusually concern may be raised by the patient or relative (personality change)

ACE III Flashcards

(32 cards)