12.17.2009

Additional clock drawings

Sometimes I think these clock drawings are revealing, sometimes just plain confusing.


This one is from a man with dementia. I don't remember much else about the case since it was awhile ago. I do remember leaving him tucked in bed, call bell in hand, last words out of mouth "call the nurse, don't get up on your own" and before I could wash my hands he was already up on his feet on the way to the bathroom. I don't remember what time I asked for, but I have to assume that it was 7:40 and we get the numbers instead of hands.


This was my first experience with the Montreal Cognitive Assessment, which is becoming my preferred pencil/paper tool. However, it does start off with alternating trailmaking and has a 5 words after 5 minutes recall section, both of which are rather difficult for many people. But it's free and more discriminating than the Mini-Mental. The MDs wanted a KELS on this lady to determine if she could go home or not, but our manual was missing so I went with a basic functional eval and the MOCA. (could have stopped after the functional eval... if you can't get your pants on, you can't go home) This lady got 2/3 points for the clock since she does have numbers and a full circle, but again has just drawn a location on the rim of the clock for the time.


Finally, my most recent, which was another attempt at the MOCA but the woman almost swung at me when I brought out the paper. So we administered the test by walking around the unit and intermittently asking questions. I find it interesting that the numbers here are counterclockwise, also semi-dyslexic with the 10 as a 01. She kept becoming confused at the time... first it was 11:10, then 3:00, then 5:30 and her hands are closer to that than anything. Ironically, she was wearing a dial watch at the time.

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