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Click ‘Get Form’ to open the dementia checklist printable in the editor.
Begin by filling out the 'Completed by' section with your name and the date of completion. This helps keep track of when the assessment was made.
In the 'Caregiver’s relationship to patient' field, specify your relationship to the individual being assessed. This context is crucial for healthcare providers.
Proceed to each symptom category: Orientation, Judgment, Communication, Engagement, Bathing and Grooming, Toileting, Physical, Nutrition and Hydration, Behavior, and Wandering and Safety. For each symptom listed, mark how frequently it occurs (Daily, Weekly, Monthly, Never).
Review your entries for accuracy before saving or sharing the completed checklist with your medical team for better communication regarding care strategies.

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What is the life expectancy of a person with dementia at 70?

increased agitation. aggression (shouting or screaming, verbal abuse, and sometimes physical abuse) delusions (unusual beliefs not based on reality) hallucinations (hearing or seeing things that do not exist)

What is the 12 question test for dementia?

The 12-question test is not just a test. Its often a self-administered screener that refers to the SAGE. This test, along with the 3-word memory test, which is a component of the Mini-Cog, assesses recall and attention, providing a comprehensive evaluation of cognitive health.

What questions do they ask in a dementia test?

The Self-Administered Gerocognitive Exam (SAGE) is a brief self-administered cognitive screening instrument used to identify mild cognitive impairment (MCI) from any cause and early dementia.

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