Mental status tests and the capacity for self-care.

To test the hypothesis that self-care capacity can be predicted by tests of mental functioning, the performances of patients in a long-term care institution on a Self-Care Scale were compared with their scores on the Short Portable Mental Status Questionnaire (SPMSQ) and a Mental Competence Scale. The Self-Care Scale measures ability to perform activities of daily living; the SPMSQ assesses memory, orientation, and calculation; and the Mental Competence Scale measures ability to respond sensibly to interview questions and to judge the environment. Many people who had poor scores on the SPMSQ were able to perform activities of daily living in the nursing home setting, but none whose scores on the Mental Competence Scale were fair or poor were independent in activities of daily living. Despite the fact that both the Self-Care Scale and the Mental Competence Scale are still in the developmental stages, the author concludes that the SPMSQ is not an adequate predictor of capacity for self-care. Moreover, the ability to respond appropriately to an interview may be more relevant for daily functioning than are tests of mental status. The three methods of assessment used in this study measure distinct yet complementary components of functioning that need to be considered in evaluating a mentally impaired elderly person.