At our facility we have a big population of Dementia patients and their mood and 
behaviors are very precarious, which we document on J5a. Behaviors may be present in 
one look back period and in another not as well as mood changes. If we were to do a 
sig chg for all these adjustments we would never get anything done. So... my point is 
if this resident has a psych history or Alzheimers, Dementia etc. and their mood and 
behavior is precarious I would not do a sig change unless this is a new behavior 
observed or a new documentation of a mood that has never been observed before.

>>> [EMAIL PROTECTED] 03/16/04 07:15PM >>>
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 ifthe 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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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
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