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Each bullet on pages 2-8 to 2-9 are not to be taken
as 1 change. A good example of this is ADLs , even though it is listed as
one bullet, if there are 2 ADLs that change a SCSA is called for (if consistent
and meets definition of change). Page 2-8 states, "This may include two
changes within a particular domain (e.g., two areas of aDL decline or
improvement)." I would include behavior symptoms and Mood in this
category. So, your resident would have had 2 changes.
----- Original Message -----
Sent: Tuesday, March 16, 2004 4:15
PM
Subject: Splitting hairs?
We have a Resident who had a sig change done in January and had
moods and behaviors, both not easily altered. He now has NO moods OR behaviors
after successful new medications. I wanted to do a significant change on him
but there was team disagreement because on page 2-8 of the RAI manual, a sig
change for decline is indicated if the Resident has 2 or more of the
following and moods and behaviors are listed SEPERATELY whereas on the
next page for improvement, where 2 or more are also indicated, moods and
behaviors are both on the same bullet line! The team feels that mood and
behaviors should be treated as one area because of this. And didnt want to
proceed to a significant change for this reason. I have always seen moods and
behaviors as seperate (depression doesnt necessarily mean a behavior problem
and vice versa).Aslo too, where they werent easily altered prior and now dont
exist at all is even more reason. Anyone have any input into this?
PS As it turned out, we did a sig change but only because he
improved in feeding skills.
Thanks
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