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