In a psychiatric hospital

Patients who are assessed after admission to psychiatric beds lack the advantages of being in their own environment, although the opportunity for physical examination is much easier. Another advantage for hospital inpatients is that the assessment can be carried out over a longer period of time, since older people tire more easily and co-operation varies from day to day. For example, some demented patients will object to undergoing full cognitive assessment in one go, especially because they are often aware that they are failing. If a few questions are asked in the course of several short sessions, a more accurate and complete picture of the patient's abilities eventually emerges. If the Mini-Mental State Examination is administered in this way, a higher total can be achieved than if an attempt to administer it all at once meets with sullen refusal after the first few questions, with all subsequent ones having to be scored zero.

Information from other informants is as crucial for hospital inpatients as it is for those seen at home. It is usually the responsibility of the house officer or resident to collect the history, and they may be required to telephone several informants in distant and local parts to obtain a full picture which the patient is incapable of providing.

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