C0800: Long-term Memory OK

Item Rationale

Health-related Quality of Life

• An observed “long-term memory problem” may indicate the need for emotional support, reminders, and reassurance. It may also indicate delirium if this represents a change from the resident’s baseline.

• An observed “long-term memory problem” should be taken into consideration in Planning for Care.

Planning for Care

• Long-term memory problems indicate the need for:

— Exclusion of an underlying related medical problem (particularly if this is a new observation) or adverse medication effect, or

— possible evaluation for other problems with thinking

— additional nursing support

— at times frequent prompting during daily activities

— additional support during recreational activities.

Steps for Assessment

1. Determine resident’s long-term memory status by engaging in conversation, reviewing memorabilia (photographs, memory books, keepsakes, videos, or other recordings that are meaningful to the resident) with the resident or observing response to family who visit.

2. Ask questions for which you can validate the answers from review of the medical record, general knowledge, the resident’s family, etc.

• Ask the resident, “Are you married?” “What is your spouse’s name?” “Do you have any children?” “How many?” “When is your birthday?”

3. Observe if the resident responds to memorabilia or family members who visit.

4. Observations should be made by staff across all shifts and departments and others with close contact with the resident.

5. Ask direct care staff across all shifts and family or significant others about the resident’s memory status.

6. Review the medical record for clues to the resident’s long-term memory during the look-back period.

Coding Instructions

• Code 0, memory OK: if the resident accurately recalled long past information.

• Code 1, memory problem: if the resident did not recall long past information or did not recall it correctly.

Coding Tips

• If the test cannot be conducted (resident will not cooperate, is non-responsive, etc.) and staff were unable to make a determination based on observation of the resident, use the standard “no information” code (a dash, “-”), to indicate that the information is not available because it could not be assessed.