Does a Montreal Cognitive Assessment score of 15/30 automatically mean my mom should not be able to be sent home from rehab?

Asked by

I help but I need to leave her alone some.

Answers 1 to 6 of 6
Usually if one takes the Cognitive Assessment test, this has to do with thinking and memory. Curious why Rehab would be involved? Rehab wouldn't be able to help the memory.
Top Answer
Do you mean whether she is mentally able to live on her own? I don't think a test score alone is able to determine that, but it may be something considered.

If she isn't able to go home, where would she go? Assisted Living? Nursing Home? Have you discussed this with the rehab social worker and/or occupational therapist?
Sandyphysics, I think a MOCA score of 15/30 is pretty solidly in the "mild dementia" level indicating that reasonable supervision is needed at home, but is probably not low enough, by itself, to suggest that a person cannot safely be sent home from rehab. As jeannegibbs implied, a MOCA score is not a full assessment of capability to perform activities of daily living (ADL), which is probably a good idea to have done before your mom is released from rehab, just so you know what adaptations to make for her comfort and safety, especially given that you expect and "need to leave her alone some."
Thanks for the thoughts. Mom is in rehab after hospital stay for infected bed sores. Her health has deteriorated since January when arthritis pain and heart failure swelling caused heel sores. The nursing home/rehab facility has her in rehab status right now but we have an ongoing conversation about the next plan. Her ADLs are improving and thus might approach the line to go home, but the 15/30 MOCA and the level of medical care she requires (20 meds to manage, daily wound dressings and elevations, heart failure diet) have made the conversation shift back and forth each day as far as the plan. The 15/30 MOCA is what scares me the most given she will soon be alone all day when I go back to work after taking a year off to help care for her. I have about a week to figure this out before she is switched to staying status or comes home, and I am tormented over what to do. I just do not know how impaired she is at 15/30. When she arrived four weeks ago to rehab, she had a 23/30, which if was accurate for her state of mind, was challenging for me to manage, but still workable.
And by arthritis pain causing heel sores, I meant the immobility that has come with that. Thanks!
Sandyphysics, I empathize with you for your situation and hard decisions you need to make. Based on the additonal information, I, too, would be scared. Your mom's 4-week decline in MOCA score from 23 to 15 makes me wonder if she has been tested for a urinary tract infection (UTI). While I'm sure MOCA scores vary depending on time-of-day, skill of the tester, mood of the testee, etc., the rapid 8-point decrease seems pretty significant to me. If she does return home in the next couple of weeks, it looks like she shouldn't be left alone for hours at a time without a trial period and/or a monitoring system in place (e.g. an audio/video link or frequent in-person checks). Adult daycare may be a good alternative to frequent monitoring -- if your mom was a war veteran or if she was married to one, then the VA may help pay for daycare.
For comparison, due to safety concerns when my now 96-year-old dad's MOCA score was 19/30 in Aug. 2013, I advised my sister-caregiver that he shouldn't be left alone for many hours at a time. My dad did not have the multiple physical and medical problems that your mom has (and still doesn't), but some of his ADL skills were quite low. Shortly after a MOCA score of 18/30 in Feb. 2014, my wife and I moved him to our home where his MOCA scored declined to 5/30 by Sep. 2016 and I ended up moving him to a memory care facility 11 months later.

Share your answer

Please enter your Answer

Ask a Question

Reach thousands of elder care experts and family caregivers
Get answers in 10 minutes or less
Receive personalized caregiving advice and support