The PASRR Technical Assistance Center helps states fulfill the goals of Preadmission Screening and Resident Review

What are some of the conceptual and diagnostic challenges of dementia and MI/ID?

It can often be difficult to determine where MI/ID ends and dementia begins. Like ID/DD, dementia can manifest as cognitive impairments. Like MI, dementia can lead to anxiety, depression, or acute behavioral problems. Even when dementia is a formal diagnosis, an individual’s MI/ID needs may still be treatable, possibly for quite some time. 

Similarly, when NF residents have tested positive at Level II (MI or ID) and then subsequently develop dementia, the onset and diagnosis of dementia does not suspend the need for the specialized services identified in the evaluation and incorporated into the individual’s plan of care. 

Both a new diagnosis of dementia and the progression of dementia symptoms could be considered a change in condition that would trigger a Level II Resident Review.  The existing specialized services may need to be reviewed and modified, based on the individual’s changing cognitive abilities as a result of the dementia. An individual’s needs will no doubt change (both in type and in intensity) as dementia progresses, but specialized services for MI/ID should continue for as long as they remain effective. 

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