Could anyone give insight as to what is on a competency test given by a neuropsychologist?

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Could anyone give insight as to what is on a competency test given by a neuropsychologist?

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Alzheimer's & Dementia Cognitive Decline Diagnostic Criteria

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It depends on the purpose and extent of the test. A full battery of neuropsych tests can take as much as four hours. I took the four-hour battery of tests broken into two two-hour sessions over two days. This was after I suffered a bad case of anesthesia-induced delirium. Several months later there were still gaps in my memory of my illness and recovery, and I was having difficulty analyzing problems and making decisions. I asked for the tests to find out what cognitive skills had been affected by my illness, how much --- and what --- I could do about it. Basically, it was a bunch of memory tests, puzzles and tests of logic, shape recognition and recall exercises, etc. Essentially, the conclusion was that yes, I had taken a hit in the area of "executive function" but that I was nevertheless functioning at a fairly high level. The neuropsychologist advised me to "use my head" to strengthen functions --- read, study, write, talk to friends, play cards and games, etc. In short, to stay mentally active. It has been a year since I took the tests and I just asked to be re-tested to see whether there have been any changes, for the better or the worse. I'll be doing that next week.

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I really admire you for being so proactive on this. Many people would have buried their head in the sand rather than do all they could to insure you live your best life. Glad you are doing well.

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My 85yo mother's exam included an over all Q&A to get a feel of where my mother's mental state was. She was asked about her family (brothers and sisters, parents), her age, her social security number, her birth date. She was asked who the current president was, and the last president. Then she had to serially count by 3s (3, 6, 9...), count backwards from 20, name the months of the year, then name them backwards. She was told a story/narrative, then asked to give a simple conclusion. A few minutes later the doctor returned to the story and asked a couple more basic questions about the it (to measure retention). From what I have read, competency exams are designed to measure reasoning/rational thought, one's the ability to understand and communicate choice and show appreciation. They seem rather abstract, but when you are in the presence with someone with, say, (un-diagnosed) dementia, as I was with my mother, it's infinitely clear that judgement and rational thought were no longer available to her. It is a very revealing test.

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My husband went through extensive testing similar to Realtime. He has been diagnosed w Parkinson’s and has had a stroke. His neurologist wanted him tested as his cognitive issues seemed more advanced than would be expected the Parkinson’s. Before the testing we met with the neuropsychologist for about an hour. He asked questions of both of us to get an idea as to what our concerns were. He used this information to decide what testing would be most beneficial. We were told the testing would be approximately 4 hours. After a few weeks we went back to see the doctor so we could go over the results. The testing results were based on an average 73 year old. It measured things like short term memory, long term memory, multitasking, etc. My husband fell below average in every category with some being “severely impaired”. He determined that the cognitive impairment was due to more than the Parkinson’s. It was a combination of the stroke, head injury (40 yrs ago) and Parkinson’s. He also told us it would continue to deteriorate and I should begin to think about getting help. He suggested exercise, memory games, reading, hobbies, social gatherings, etc to keep his brain as active as possible. We will go again next year to retest. I found the testing helpful for me as it answered many of my questions and also gives me insight as to his abilities and what the road ahead looks like.

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At the start the examinator will tell the patient that they are going to say 4 words....remember them, I will ask you to repeat them later.

then they ask basic things like...who is the current president of the USA? What month is this? Etc. and basic conversation about what they like to do..etc.

at the end, they will ask for those words back.

the test is for short term memory and to see if they can retain new information...that would be important to figure out if they can reliably handle medications and changes in medications.

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I sat while Mom did this back a few years ago. And I couldn't remember the 4 words.

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From report of my mother's testing: Boston Naming Test, Phonemic and Conceptual Fluency, Clock Drawing, WAIS-IV (Selected Subtests), Trailmaking Test Parts A & B, Wechsler Memory Scale-IV: Logical Memory I & II, Visual Reproduction I & II with recognition, President's Test, Token Test, MMSE, Shipley: Abstraction, Beck Depression Inventory. If you google the individual names of tests and look at images, you'll see some accurate representations of some of them. A lot of the tests are measuring task switching and mental flexibility--can the person switch easily between topics, categories, tasks? In real life conversations, we switch rapidly from topic to topic, but the tests are actually more difficult than real life conversations and other real life contexts. The tests force someone to continuously think on their feet for several hours at a time, which is hard in itself. It's also harder when these are basically meaningless tasks with no goal and no tangible outcome. I think people might try harder if they had a reward to shoot for. They also might try harder if they knew how much of their fate was riding on these seemingly meaningless tests!

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Thanks so much Beekee!

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Thank you guys so much...all of the info that I can get helps right now.
My stepdad is going through this right now due to his greedy children wanting to take over and is not incompetent nor does he need a conservator but is having to take the test. He is 81 but is sharp as a tack, except occasionally forgetting what day of the week it is at times, but then quickly remembers. Poor thing is worried sick about what all it will entail.

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Since I have been retired I have to question what day it is. Come back and tell us if he passes. I pray he does.

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I can't even remember 2 words. And yet I hold a technical job and manage my parents and my own affairs. The test assumes one watches the news and cres who is president. But the news is too gory and my parents chose not to watch TV but to read favorite books and magazines. The test is inadequate useless. Should be revised. I saw a young lady administer the questions and then the neurologist did an assessment of level of dementia. Just days before an MD had documented initial, mild mental decline normal for age.

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I think neuropsychologists are full of it. Totally useless people. But get paid exorbitant sums of money to diagnose things that cannot be cured.

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My experience is it has been three words. An assistant of some sort asks questions for about 15 minutes then the neurologist comes in and asks a few more. They do it within about a half hour.

Unfortunately all the times I’ve watch this, neither one of them are that patient For the answers. They’re very simplistic questions. Sometimes so irrelevant I wish that they would try to be more relevant to their life something that was meaningful and practical for them to know instead of from the world of the younger working person.

I’ve had trouble to remembering the words LOL. And anybody out of their routine I think loses track of the Date and Day. Especially if their stress in their life. I remember working hurricane Katrina is a shelter manager and every facility that I went into posted not only the date but what day it is right next to it because it was so hard to keep track.

I would try to make sure my clients were well fed, bathed and groomed So they would feel they were at their best for the appointment. I would brief them before we went, and Once there and I would be supportive if I thought someone was being insensitive to them. A true mother Hubbard ha ha.

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I don't think they take the words as their primary diagnostic tool. The really important thing is drawing the (analog) clock face at a specific time. The doctor can tell by how far off the patient is when placing the numbers, and where the problems start just how far along the dementia is. But some patients can pull off the clock and still be well into their dementia. The interview seemed to settle it with my mother's doctor. Just don't interrupt or try to answer for her, so the doctor gets an accurate view.

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neuropsychologists in my opinion are useless and there are no tests for Alzheimer's disease other than behavior. If she is able to answer any kind of questions at age 85 she is doing good! At age 85 my mom was wandering and totally confused. She is almost 90 now and on hospice care and cannot do anything for herself. I've been dealing with her Alzheimer's for 20 years now; there is no medication or cure, and psychotropics only mask symptoms and increase likelihood of falling.

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Sorry you had a bad experience. I have found them extremely helpful. My mother had a full battery of cognitive tests including an IQ test. It should her cognitive functioning was about the level of a 12 year old and that she understood more with visual info that verbal. Of course a neuropsychologist can't diagnose AD, they are not medical doctors and only an autopsy can make that definitive diagnosis.

Could anyone give insight as to what is on a competency test given by a neuropsychologist?

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