C0400: Recall

Item Rationale

Health-related Quality of Life

• Many persons with cognitive impairment can be helped to recall if provided cues.

• Providing memory cues can help maximize individual function and decrease frustration for those residents who respond.

Planning for Care

• Care plans should maximize use of cueing for resident who respond to recall cues. This will enhance independence.

Steps for Assessment

Basic BIMS interview instructions are shown on pages C-4 and C-5.

1. Ask the resident the following: “Let’s go back to an earlier question. What were those three words that I asked you to repeat?”

2. Allow up to 5 seconds for spontaneous recall of each word.

3. For any word that is not correctly recalled after 5 seconds, provide a category cue (refer to “Steps for Assessment,” page C-8 for the definition of category cue). Category cues should be used only after the resident is unable to recall one or more of the three words.

4. Allow up to 5 seconds after category cueing for each missed word to be recalled.

Coding Instructions

For each of the three words the resident is asked to remember:

• Code 0, no—could not recall: if the resident cannot recall the word even after being given the category cue or if the resident responds with a nonsensical answer or chooses not to answer the item.

• Code 1, yes, after cueing: if the resident requires the category cue to remember the word.

• Code 2, yes, no cue required: if the resident correctly remembers the word spontaneously without cueing.

Coding Tips

• If on the first try (without cueing), the resident names multiple items in a category, one of which is correct, they should be coded as correct for that item.

• If, however, the interviewer gives the resident the cue and the resident then names multiple items in that category, the item is coded as could not recall, even if the correct item was in the list.

Examples

1. The resident is asked to recall the three words that were initially presented. The resident chooses not to answer the question and states, “I’m tired, and I don’t want to do this anymore.”

Coding: C0400A-C0400C would be coded 0, no—could not recall, could not recall for each of the three words.

Rationale: Choosing not to answer a question often indicates an inability to answer the question, so refusals are coded 0, no—could not recall. This is the most accurate way to score cognitive function, even though, on occasion, residents might choose not to answer for other reasons.

2. The resident is asked to recall the three words. The resident replies, “Socks, shoes, and bed.” The examiner then cues, “One word was a color.” The resident says, “Oh, the shoes were blue.”

Coding: C0400A, sock, would be coded 2, yes, no cue required.

Rationale: The resident’s initial response to the question included “sock.” They aregiven credit for this response, even though they also listed another item in that category (shoes), because they were answering the initial question, without cueing.

Coding: C0400B, blue, would be coded 1, yes, after cueing.

Rationale: The resident did not recall spontaneously but did recall after the category cue was given. Responses that include the word in a sentence are acceptable.

Coding: C0400C, bed, would be coded 2, yes, no cue required.

Rationale: The resident independently recalled the item on the first attempt.

3. The resident is asked to recall the three words. The resident answers, “I don’t remember.” The assessor then says, “One word was something to wear.” The resident says, “Clothes.” The assessor then says, “OK, one word was a color.” The resident says, “Blue.” The assessor then says, “OK, the last word was a piece of furniture.” The resident says, “Couch.”

Coding: C0400A, sock, would be coded 0, no—could not recall.

Rationale: The resident did not recall the item, even with a cue.

Coding: C0400B, blue, would be coded 1, yes, after cueing.

Rationale: The resident did recall after being given the cue.

Coding: C0400C, bed, would be coded 0, no—could not recall.

Rationale: The resident did not recall the item, even with a cue.

4. The resident is asked to recall the three words. The resident says, “I don’t remember.” The assessor then says, “One word was something to wear.” The resident says, “Hat, shirt, pants, socks, shoe, belt.”

Coding: C0400A, sock, would be coded 0, no—could not recall.

Rationale: After getting the category cue, the resident named more than one item (i.e., a laundry list of items) in the category. The resident’s response is coded as incorrect, even though one of the items was correct, because the resident did not demonstrate recall and likely named the item by chance.