Ask the Care Expert about... mini-mental state exams

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

We have a dementia unit and currently use a mini-mental state examination on our admissions. We have heard the mini-mental may not be the best test  -—  do you know of any other that may be better?

There are many versions out there, but some of the top dementia folks in the country use the SLUMS — St. Louis University Mental Status Exam. 

No matter what exam you use, be sure you train all of the nurses who will be administering it. Not everyone waits the same amount of time between questions, or will ask the questions in the same order. 

If they are pressed for time, nurses might skip questions, not allowing for a true score, or they might not take a pencil and paper with them to administer the test. 

This particular exam asks for a clock and a triangle to be drawn. If the nurse does not take paper, there are two questions that can't be done.

If you want the test done within a certain amount of time after admission, be sure they know your time limits. You might think, “Oh, it's no big deal … anyone can do this.”

I suggest at a nurse training, have them take the test. They will then have a mental image of how it should be done, and understand guidance. 

Perhaps even show them a simple “cheat” sheet to go along with the test to remind them to take paper and a writing instrument for the resident. 

Keep in mind — no matter what mental test you do, make sure it is done in its entirety. Staff should not skip steps, and be routinely trained on how you would like the test administered.  

Try not to change your test and procedures too often or you will not have one consistent test being performed! 

Get your team involved if you are considering making a change.