Mental Assessments

At Kathelene’s Compassionate Adult Day Health Services, we provide both geriatric and mental health assessments. Our top clinicians are well-versed in a wide-range of geriatric psychological and physical abilities. It is our mission to assess the needs of your loved one in order to provide unique and engaging services and activities.

Medications and prescriptions are an important part of every assessment; time-of-day and dosage amounts will be integrated into each person’s unique plan. Here at Kathelene’s, we want every individual fully engaged. We believe that it is necessary to take note of recreational interests and any fears or phobias that may obstruct the healing process.

Free Respite Provided
Every 2nd and 4th Wednesday, 1:00 p.m  - 2:30 p.m.
Every 2nd and 4th Tuesday 6:00pm - 7:30pm

 

 

Mental Assessment

First Name *
Last Name *
Person Completing This Form *
Email *
Contact Number *

Mood *
  No Issues
  Occasional sadness or bouts of crying
  Feelings of hopelessness, loneliness
  Manic behavior such as over-eating, overspending, hyper
  Suicidal thoughts

Delusions *
  No Issues
  Sometimes has a difficult time distinguishing between actual events and perceived information
  Strong sense of being ‘correct’ despite apparent proof
  You see or hear things others do not

Eating *
  No Issues
  Minor weight fluctuations
  Over-eating or signs of malnutrition
  Obesity or signs of Anorexia (Gain or loss of 50 pounds in a 6-month period)

Sleep *
  No Issues
  Occasional complaints of not sleeping or disrupted sleep patterns
  Frequently oversleeping/not sleeping
  Sleep interfering with normal function
  Take a medication to help you sleep

Hygiene *
  No issues
  Bad breath, unbrushed hair, body odor, or food-stained clothes
  Underwear and clothes worn multiple days in a row
  Fecal/urine stained clothing

Speech *
  No issues
  Slurring
  Inability to find words
  Nonsensical speech

Behavior *
  No Issues
  Argumentative or irritability
  Withdrawn or unresponsive, obsessive compulsive behavior, aggression/lashing out
  Unable to go out into public or relate to people

Anxiety *
  No issues
  Fearful of new situations
  Physical symptoms such as: sweating, breathing issues, increased heart rate, etc.
  Hinders everyday functionality – afraid to leave the home

Diagnosis *
  Depression
  Bipolar
  Schizophrenia
  Post Traumatic Stress Syndrome
  OCD
  Addictions

This assessment is designed specifically to gather information. It is not a diagnosis or treatment of a mental health or physical condition. If this is a medical emergency, please contact your physician or go to the nearest emergency room.

 

Kathelene’s Compassionate Adult Day Health Services
25820 Orchard Lake Rd., Farmington Hills, MI 48336-1248
(248) 313-2275 • info@farmingtonhillsadultdaycare.com
Homepage for Kathelene's Compassionate Adult Day Health Services in Farmington, IL