| RPT |
.| Rating Anxiety In Dementia - (RAID)| |
RAID TOTAL SCORE = <*Answer_999999999999*>||
A score of 11 or more suggests significant clinical anxiety.|||
Questions and Answers||
1. Worry: Worry about physical health.|
<*Answer_8382*>||
2. Worry: Worry about cognitive performance (failing memory, getting lost when out, not able to follow conversation).|
<*Answer_8383*>||
3. Worry: Worry over finances, family problems, physical health of relatives.|
<*Answer_8384*>||
4. Worry: Worry associated with false belief and/or perception.|
Date Given: <.Date_Given.>|
<*Answer_8385*>||
5. Worry: Worry over trifles (repeatedly calling for attention over trivial matters).|
<*Answer_8386*>||
6. Apprehension and Vigilance: Frightened and anxious (keyed up and on the edge).|
<*Answer_8387*>||
7. Apprehension and Vigilance: Sensitivity to noise (exaggerated startle response).|
<*Answer_8388*>||
8. Apprehension and Vigilance: Sleep disturbance (trouble with falling or staying asleep).|
<*Answer_8389*>||
9. Apprehension and Vigilance: Irritability (more easily annoyed than usual, short tempered and angry outbursts).|
Clinician: <.Staff_Ordered_By.>|
<*Answer_8390*>||
10. Motor Tension: Trembling.|
<*Answer_8391*>||
11. Motor Tension: Motor tension (complain of headache, other body aches and pains).|
<*Answer_8392*>||
12. Motor Tension: Restlessness (fidgeting, cannot sit still, pacing, wringing hands, picking clothes).|
<*Answer_8393*>||
13. Motor Tension: Fatigability, tiredness.|
<*Answer_8394*>||
14. Autonomic Hypersensitivity: Palpitations (complains of heart racing or thumping).|
Location: <.Location.>| |
<*Answer_8395*>||
15. Autonomic Hypersensitivity: Dry mouth (not due to medication) sinking feeling in the stomach.|
<*Answer_8396*>||
16. Autonomic Hypersensitivity: Hyperventilating, shortness of breath (even when not exerting).|
<*Answer_8397*>||
17. Autonomic Hypersensitivity: Dizziness or light-headedness (complains as if going to faint).|
<*Answer_8398*>||
18. Autonomic Hypersensitivity: Sweating, flushes or chills, tingling or numbness of fingers and toes.|
<*Answer_8399*>||
Phobias: (Fears which are excessive, that do not make sense and tends to avoid - like afraid of crowds, going out alone, being in a small room, or being frightened by some kind of animals, heights, etc.).|
Veteran: <.Patient_Name_Last_First.>|
Describe:|
<*Answer_8400*>||
Panic attacks: (Feelings of anxiety or dread that are so strong that they think they are going to die or have a heart attack and they simply have to do something to stop them, like immediately leaving the place, phoning relatives, etc.).|
Describe:|
<*Answer_8401*>||
Information contained in this note is based on a self-report assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities.||
$~
SSN: <.Patient_SSN.>|
DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)|
Gender: <.Patient_Gender.>||
Status at Evaluation: <*Answer_8380*> <*Answer_8381*>|||
|
