Part 2 of 2 cont. of Gail's response to Janet:

** The problem is I'd have to observe you to fill out this form, but
here goes with my internet assessment <G> **

 I.Mentation, Behavior, Mood

        Intellectual Impairment
            0-none

        Thought Disorder
            0-none


        Depression

            2-sustained depression for >1 week

        Motivation/Initiative

            2-loss of initiative or disinterest in elective activities


II.Activities of Daily Living

   Speech

      1-mildly affected, no difficulty being understood

   Salivation
       1-slight but noticeable increase, may have nighttime drooling


    Swallowing

        1-rare choking


     Handwriting

        2-all words small but legible


     Cutting Food/Handing Utensils

         2-can cut most foods, some help needed


     Dressing

         1-somewhat slow, no help needed


     Hygiene

          2-needs help with shower or bath [or] very slow in hygienic
             care


 Turning in Bed/ Adjusting Bed Clothes

     2-can turn alone or adjust sheets but with great difficulty


  Falling-Unrelated to Freezing

     2-occasional, less than one per day


  Freezing When Walking

     3-frequent freezing, occasional falls
      [they put these 2 together, if you freeze frequently that's a 3
even if you've never fallen]

   Walking

     2-moderate difficultly requires no assist

 Tremor

     3-severe, interfere with many activities


 Sensory Complaints Related to Parkinsonism

   2-frequent, but not distressing

III.Motor Exam

 Speech

   1-slight loss of expression, diction,volume


 Facial Expression

   2-slight but definite abnormal diminution in expression


 Tremor at Rest
[[I don't know your most effected side, I'll guess left for this]]

    Face

       2-mild and present most of time

    RUE....Right Upper Extremity (RUE)

       3-moderate and present most of time


    LUE .....(left upper extremity)

        4-marked and present most of time

[[unless medicated with enough medicine to put Gail on her butt]]


     RLE  (right lower extremity)

          3-moderate and present most of time


     LLE  (left lower extremity)

           4-marked and present most of time


   Tremor at Rest

        Face

                2-mild and present most of time

         Right Upper Extremity (RUE)

                2-mild and present most of time

          LUE

                3-moderate and present most of time


            RLE

                2-mild and present most of time

            LLE

                3-moderate and present most of time


        Action or Postural Tremor

            RUE

                2-moderate present with action


            LUE


                3-moderate present with action and posture holding


        Rigidity

            Neck

                3-marked, full range of motion


            RUE

                3-marked, full range of motion


            LUE

                3-marked, full range of motion


            RLE

                2-mild/moderate


            LLE

                3-marked, full range of motion


        Finger taps

            Right

                2-moderate impaired. Definite and early fatiguing, may
have occasional arrests

            Left

                3-severely impaired. Frequent hesitations and arrests.


        Hand Movements (open and close hands in rapid succession)

            Right

                2-moderate impaired. Definite and early fatiguing, may
have occasional arrests


            Left

                3-severely impaired. Frequent hesitations and arrests.


        Rapid Alternating Movements (pronate and supinate hands)

            Right
                2-moderate impaired. Definite and early fatiguing, may
have occasional arrests

            Left
                3-severely impaired. Frequent hesitations and arrests.


        Leg Agility (tap heel on ground, amp should be 3 inches)

            Right

                2-moderate impaired. Definite and early fatiguing, may
have occasional arrests

            Left

                3-severely impaired. Frequent hesitations and arrests.


        Arising From Chair (pt. arises with arms folded across chest)

            3-tends to fall back, may need multiple tries but can arise
without assistance


        Posture

            2-definitely abnormal, mod. stooped, may lean to one side

        Gait

            2-walks with difficulty, little or no assistance, some
festination, short steps or propulsion

        Postural Stability (retropulsion test)

            2-would fall if not caught

        Body Bradykinesia/ Hypokinesia

            4-marked slowness, poverty, or amplitude

Margaret Tuchman (55yrs, Dx 1980)- NJ-08540
[log in to unmask]

==========================

Janet,

I'm evaluating you (by some descriptions you mentioned over the internet
over the 6-8 months I've known you) at scoring 111 points on this
scale.As I've said, this is an illness perspective, not a wellness
perspective.

Gail Vass, RN, BSN