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Topic WAIS-IV Test for Memory/concentration etc Go to previous topic Go to next topic Go to higher level

By karolinakitty On 2009.12.04 08:28
Not sure if i should post this here or in the other discussions but ya'll can move it if you think it needs it.

Several months ago i posted that my man was gonna receive this large memory/concentration test from disability to see what was up.
I just received a copy of that from our disability lawyer who seemed to be the only able to receive it. We were not allowed to personally receive it.

I don't know if anyone else has had this test with "good" results, but I think this doc, payed by disability was biased with diability.
His main focus in his determination was my mans calmness, "fu manchu" and tatoos. This is no sign of memory nor intelligence. As i have stated in prior posts, he is very intelligent and in most cases will carry on intelligent conversations and knows so many different things. He had no college education, but talking with him you would think he did.
I thought the main focus of this test was memory and conentraion but it focused more on intelligence.
He scored "normal" on the memory part and don't understand how. One thing he did remember from the test was the fact that he was showed pictures of about 30people and then along time after showed another set of pictures, and was asked to identify who was in the first set. He knew he did bad on that part, and i know he did also because of just regular socialization.
Many of the issues we all seem to deal with in regards to memory/concentration were not dealt with in this test from what i saw from the results and the description of this test.
Now, whether this Dr. is payed by Voc Rehab or not, testing should be impartial. I don't think that happened in this case due to the observations by the doc. He must have repeated 10 times in his report the fact that he was calm. One problem with my man is the fact that he gets frustrated and goes blank when handling overwhelming mental tasks. Uhhhh ... doesn't the doc think that's what happened? Not that he was calm, but that he was "not there", stoic or foggy?
His neuro, whom actually called me personally after i sent the letter about his nurse, said he could not understand this doctors results either. He was the one that originally told me the results from this test. He was mistifyed as to how he could be considered "normal", in memory. We have an appointment to see him in a few weeks and he plans to go over this mess with us.
He suggested we find a neuropsychologist to adminster a test similiar to this that deals with what part of the brain IS affected and how "deep" the memory/concentration issues are. This test is expensive but it may be worth a try.

Sorry this post is so long, but many issues are involved.
One thing my man scored average on was math skills, this supposed gives him the abilities to keep accounting records according to this doc. I think due to his intelligence YES he could, BUT, his memory for making entries is NOT. he knows the values of money and did many algebraic equations on this test. OF course, intelligence, not memory. What they fail to take into account is that you have to enter debits and credits to keep books, not just do the math.

I did some research on line and found this test has its controversies, yet i couldn't find any direct writings on that subject.
I'm sure annwood, due to the fact your husband was a doctor and had high intelligence you might know what i'm dealing with.
The intelligence of a human does not mean they don't have memory or concentration issues.
The only part he did get right on his results was his slowness to respond. According to this doctor, while the inteligence is there his answers were slow in repsonse and this 2 hour test took him 3.5 hours to do.
One more thing, then i'll quit.....
He also did a psych profile.. due to the fact my man has bi-polar and PTSD, he also stressed, again, his clamness in regards to his frustration and slowness during the test.
I'm no psychologist, but i see this man everyday, in everyday activities. This is not calmness but the masked facial expressions and the mind and body not reacting as with the "norm".
My man has always been non-confrontational, and i still doubt this bi-polar diagnosis, maybe the trauma to the brain did something to counter act this daignosis. His non confrontational ideals may also give off this calmness.

In closing, i never knew caregiving involved getting a doctrate in all medical and social areas, but i guess that is what we need to do. To collect all the info we can, store it and use it when me must.

By annwood On 2009.12.04 11:03
I sense your frustration. Standardized tests have many problems. You may recall black children being rated as below normal on testing and then it turned out that they did not have the same life experiences as the whites who wrote the test. In all of this you have to keep in mind that the purpose of this testing is to determine disability and the goal is to prevent people from getting disability. Try not to take it personally that is just the way the testing is organized. I would question how much the physician knew about PD as a disability and lacking the knowledge of the PD masking could account for his comments on calmness. The neuro/psych eval that your neurologist is talking about is a better test but expensive. It is doubtful that the results woud be recognized by the disability people since they are obligated to go only by their standardized test. If you are just wanting the info for yourselves consider it.

Like Jim, my husband was intelligent and when he demonstrated a 50% reduction in IQ post DBI he still fell in the average range. Until his dying day he could tell you precisely how to do a complicated surgical procedure; however he did not know who you were and he preferred giving his "lecture" naked. He couldn't find the bathroom but he could tell our granddaughter that Northwestern had the best combined MD/PhD program. If you asked him to do something he forgot what it was by the time he got to the other side of the room. Strange how the mind works.

I think that as a cargiver by the time you have graduated from this crash course on PD you do have a doctorate in the subject. You know more than most MD's and RN's unless they deal directly with PD (still may know more even then).

P.S. Glad you got that call from the doc regarding the nurse. In addition to making yourself feel better, you probably have made things much better for many other patients.

By Mary On 2009.12.04 11:58
It is frustating as a caregiver in every aspect, including making sure our loved ones get proper medical care. When I would bring Dad to the neurologist, he would be asked the same questions: what day is it, what is the date, who is the president and what were the last three words I asked you to remember at the last visit. Well, Dad would practice these answers and ask me what the correct answers were. I told him that he wasn't doing himself any favors by cheating like that but Dad did it anyway. I told the neurologist about it and he continued asking the same questions every visit. I also feel like I have a PhD in Parkinson's Disease based on experience and research. I pray they find a cure very, very soon. No one should have to live this way, no one. Hugs and blessings, Mary

By LOHENGR1N On 2009.12.04 16:51
Several, maybe 15 to twenty years ago. My Neurologist was contacted by a post grad student working on Her thesis for memory and cognitive losses to Parkinson's Disease. My Doc asked if I'd be willing to take part.

Sure what the heck I thought, plus it would give me the chance to discuss more in depth Her questions and what She hoped to prove or disprove. .......The test......entering the room a timer clock sat on the table. Idle chit chat then She set down 4 blocks split diagonally half white, half red. Opening a book She pointed out a pattern (puzzle) to make........ok start...ok I'm done! After about 5 puzzles She stopped Me. I can't do this test with you She said. Why? Because the book says the time to complete one should be between a minute and one half to three minutes, You're longest one took you twenty seconds! Then She brought out 9 blocks and opened deeper into the book. Ok try these......3 puzzles later STOP! I can't time you, you're under a minute each when the book says 5 to 9 minutes! I asked if She was planning on testing Us at a later time to see if cognition and memory were impaired? No She was planning to test others in same age group to see if results were markedly different. You can't do that I said. I've got a background in fabricating, building from blue prints. Taking parts and building according to plan. I had worked carpentry and welding trades. If you take a book keeper or a teacher and test them how can you expect them to perform manual tasks like puzzles as well as someone who basically works 8 hours a day doing these things? If their backgrounds are not the same or at least close as can come to mine then the results are useless! .... So on to memory, She read short stories. I answered who had what color shoes on and what time they left etc, etc. Until Sam got into a truck driving a load of fish up from Kentucky to Mississippi. When She asked a question about where He stopped for gas I told Her ....(hehehe) I don't know, when you said he drove up to Mississippi from Kentucky He was headed in the wrong direction so I figured you were trying to trick me and stopped listening as He would never get there. I never heard back from Her on Her findings nor did My Neurologist.

To make this long story short this is a problem with a lot of testing. They hardly put the effort into research and recording correct data per each individual or at least similar background, instead it's grouped into the "normal" test results. In such cases there isn't a normal. It seems to me that in our fast paced society the rush is to be recognized as soon as possible. To skew data to fit the wanted outcome. This worries me in research going on and in the field as a whole. The waters are so muddled by trying to pigeon hole everyone that the Individual is lost to view. I wonder just how great a job those in "authority" would think was being done if it were a loved one of theirs being treated this way? Take care, best of luck and hang in there.

By Emma On 2009.12.05 05:54
I agree that a full neuropsychological test is a better option. The test, and the people who administer it, are more geared to the subtle issues that occur with neurological conditions and dementia. I've found them to be pretty much spot on with my husband. I don't know what kind of insurance your husband has, but Medicare and our private insurance paid for the testing. I also don't know what kind of disability you are applying for, but if it's Social Security Disability and he gets turned down you can appeal. Then you can have the doctor who does the neuropsych submit his/her test results., so in the long run it might be helpful.

Also, if you are applying for Social Security Disability, I used to work for an agency that did a lot with Social Security. I know that they don't give a whit if your doctor thinks a person is disabled or can work and one of the main reasons people get turned down is that their doctor doesn't submit the kind of information they're looking for. All they want from the doctor is FACTS, ie; test results, not opinions. From you, on the application, they want to know how the disability prevents the person from working, at any job, not just the job they previously held. When I applied for my husband I copied some information from the Social Security website regarding what they were looking for and sent it to his doctors along with a letter saying lets do this right the first time so that we don't have to do it again. On the actual application you can submit extra pages so I made a chart listing each symptom on one side and what skills were affected by it on the other.

It's too bad that we have to struggle so much with all of this, as if things aren't hard enough already. Good luck to you.

By hubb On 2009.12.05 12:17
Just to add another story to cognitive testing...my husband gets tested each time prior to seeing the neurologist as he is part of a teaching hospital and we always have a graduate student administering the tests...spell world backwards, remember 3 objects, etc. One time the young lady had pointed to various things for him to tell her what they were and pointed to her foot. He replied shoe and she said I wanted more, so he said woman's shoe. She said I was looking for clog. My husband would never in the world have known a woman's shoe was a clog. He said he felt like saying ugly shoe. And another point I wanted to reiterate was I believe Al mentioned wearing sweats. We have found that to be so much easier both on him and on me. He can sometimes dress himself wearing sweats and if I have to help, it's easy. Also much easier on him when he has the urgency for the bathroom and is so slow to be able to get there - at least they don't have the buckles and zippers to confront them. He is going through rapid personality changes and I'm afraid that's the beginning of dementia. We have an appointment next month with neurologist so will see what he says, but he's been very argumentative, confrontational about everything, and nothing is good enough or I don't respond quickly enough. This is when it is really tough on the caretakers - sometimes you feel like walking right out the door and never coming back even though you know you won't, and just have to remind myself constantly that's he's not the same person, he wasn't really like this and try to stay calm so he will be as calm as he can. Tough old road we travel.

By karolinakitty On 2009.12.06 00:43
Thanx Gang ....

We are down to our last appeal where the lawyer gets involved, what's good is no upfront money for them and Social Security puts a cap on their total amount, so that's good also. The lawyer thought too that the neuro/psychologist testing might be helpful.
Yeah Jim gets tested everytime we go the neuro prior to his coming in. same questions each time, yet he don't realize it. the one time after the nurse gave the test i told her it wasn't fair. she looked at me funny, then i reminded her about the three words to repeat, apple orange and penny...well, Penny is my name so he got that one right.
Jim's IQ prior to PD was genius, now a few years later he tests post high school. His is a wide knowledge, or useless trivia as he calls it. However he can still give you the whole story about the Mayan's and 2012 and even discusses it with some of our friends that are of Mayan decent. He can tell you about his first Mach truck he drove, and the routes he took up and down the West Coast, but he couldn't tell you five minutes after he met you what your name is.
Since my letter to the doc worked, maybe if i state all the facts, sending a letter to Social Security, local house of reps, and Senators about this testing, might shed a little light in their world. Not that anyone would hear it all but they might hear one word...
Al .. i brought attention once before about your quote on teaching about PD. i think this falls into that category too. While all PDrs are from different backgrounds, different symptoms, just different, that "generalized" testing isn't general with them.

By LOHENGR1N On 2009.12.06 09:05
karolinakitty, This site may be of some help to you http://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm#11.06ParkinsonianSyndrome click on this link. It's very frustrating trying to get benefits. I also had a hard time, for some they just seem to encounter no problems for others it's a knock down drag out fight! I hope that this site helps. Take care, best of luck and hang in there.

By karolinakitty On 2009.12.07 08:00
Thanx AL ..I've read it before ...bookmarked it and had a copy when we went to the lawyers. I guess the big obstacle we face is intellegience. The woman at the pharmacy told me about her husband who went blind. They denied at one appeals hearing, due to the fact he had intellegience. The second appeals judge said it was ridiculous he was denied, he "blames" it on the ADA. While it gives those trained the rights to get jobs, it sort of takes away the fact that those who have had no "training" can't get disability. So we fight on like everthing else with this disease.
I guess in his case gram's old saying.."Your too smart for your own good" ..is literal...

By bandido1 On 2009.12.09 16:26
karolinakitty:

I’m sorry to be getting a little late into this thread but have been busy working on other projects including the book collaboration with 10 other patients.

After reading everything through this date I thought it best to synthesize my comments and simply deal with the issue at –getting the disability benefits.

First, I should refer you to a search of my posts which may take you back to a NEUROPSYCHOLOGICAL EVALUATION of me done in Feb 2007. This was in conjunction with my initial diagnosis and consisted of over 20 assessment techniques including the WASI, WRAT-3, and 18 others testing every aspect of my brain relating to cognitive capabilities.

In a comment labeled Mini Mental Status Exam, the examiner wrote” he was fully oriented to time and location. He was able to repeat three out of three words and recalled all of the words following a very short delay. He was unable to complete serial sevens but spelled a simple word backwards. He was able to follow a written command and complete tasks of naming and reading. He was unable to accurately complete a three step instruction. He was able to generate and write an original sentence and repeat a simple sentence. He was able to reproduce the primary elements of some of overlapping figures.”--------sound familiar?

Notwithstanding the above quote, I managed to pass the examination which ran for almost two days. This evaluation was covered by Medicare and my private insurer. I fail to see how people responsible for approving disability claims would differ in their approach to payment of benefits. Keep on fighting and best of luck. Bob C

P.S. I can still spell backwards except for the spelling of LOHENGR1N. What’s with the 1 Al?

By LOHENGR1N On 2009.12.09 16:38
Bob I had to change the i in my screen name to the number 1 else if anyone looked it up they'd be diverted to the opera by Wagner or to the story of Lohengrin. Or in simple terms Aol wouldn't accept it as a screen name lol.

Now to the disability question I'm sorry Bob (some tough love here) age has a lot to do with the determination process. It's harder to get benefits the younger you are. In fact when I was battling for benefits Parkinson's Disease wasn't even on their list of impairments as it was considered a "Disease of Old Age". Hence the problems with views of disability awards. Take care, best of luck and hang in there.

By karolinakitty On 2009.12.09 17:48
Sounds real familiar bandido ........
just to add a "funny"
Mr. Jim is a 52 yr old, obese, caucasian male who looks much older than stated. He has a Fu Manchu mustache and speaks in a gravelly tone. He walks with the aid of a cane. His gait is slow and unsteady. His manner was calm and effort was put forth to answer questions.
In terms of mental status, he states he is in a fog and gets in a state of sheer panic. He denies any suicidal or homicidal ideation or intent.
Mr. Jim certainly has the capabilities of performing in a work related setting. He iniatiates activities independently and is in a romantic relationship.

Since when did being in a romantic relationship have anything to do with memory or concentration, or even holding down a job?
Oh and this was the fourth time he mentioned the obese, fu manchu, and calmness. before each result he gave a "summary" and each time mangaed to throw those things in there.... Uh...it was still the same person as it was at the beginning of the test. He didn't shave or lose weight or we didn't get a divorce either, by the end of the test. What a crack pot .... i just think this doc is over his head and needs an evaluation himself......

We will hang in there until it's all said and done. I talked to the attorney and thinks between his doc and some experts we may be able to refute this test and show prejudice in his recommendations........

By mylove On 2009.12.09 20:26
Just to add my two pennies....

I see your aggravation with the evaluation - it's a shame that someone in a clinical setting can't ever see just what the family sees. Diseases seem to be like noises in your car - when you take them to the specialist, you're the only one who can hear them so that they can get identified correctly!

I was a nursing student (long long ago- lol), and the first paragraph of your evaluation are what we called 'patient observations'. (age, body type, race, demeanor, orientation to his surroundings, obvious disabilities, etc). They called this the objective portion, if I remember right, and they stressed the relevance of these observations in our training. Sometimes the smallest and seemingly inconsequential things can be a clue to what is going on. (Ever watch "House, MD"? King of the patient observations.)

The second paragraph is the findings - what the evaluator obtained from the interview. This part is more subjective and shows what they deduced from talking to the patient. As far as what being in a romantic relationship has to do with cognition - that shows that his social skills and emotional/mental capacities are still sufficiently intact as to be able to relate to another person - similar to being able to hold down a job. Those skills tend to correlate and decline in conjunction with mental decline.

What the fu manchu has to do with anything? I think the guy was fascinated/fixated on it! LOL I can't think of a single clinical significance of a mustache style. Unless he was admiring the manual dexterity required to keep it trim! ;)

Hang in there. Hope your next steps go easier...


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