| RPT |
|COHEN-MANSFIELD AGITATION INVENTORY (CMAI)
| Gender: <.Patient_Gender.>
|
| Aggressive Behavior = <-AGGRESSIVE->
| Physically Non-Aggressive = <-NON-AGGRESSIVE->
| Verbally Agitated = <-AGITATED->
| Other Behavior = <-OTHER->
| CMAI Total Score = <-TOTAL->
|
| Scores can range from 0-25, with higher scores indicating worse
| symptomatology.
|
|
| A total score of 12 or above suggests the patient
| might benefit from further assessment and treatment by a mental
| health clinician aimed at addressing their anger difficulties.
|
|Questions and Answers:
|
| 1. Cursing or verbal aggression
| <*Answer_9158*>
| 2. Hitting, kicking, pushing, biting, scratching, aggressive
| Date Given: <.Date_Given.>
| spitting
| <*Answer_9159*>
| 3. Grabbing onto people, throwing, tearing, or destroying
| things
| <*Answer_9160*>
| 4. Other aggressive behaviors, including: intentional falling,
| making verbal/physical sexual advances, eating/drinking/chewing
| inappropriate substances, hurt self or other
| <*Answer_9161*>
| 5. Pace, aimless wandering, trying to get to a different place
| Clinician: <.Staff_Ordered_By.>
| (e.g. out of the room, building)
| <*Answer_9162*>
| 6. General restlessness, repetitious mannerisms, tapping,
| strange movements
| <*Answer_9163*>
| 7. Inappropriate dress or disrobing
| <*Answer_9164*>
| 8. Handling things inappropriately
| <*Answer_9165*>
| 9. Constant request for attention or help
| Location: <.Location.>
| <*Answer_9166*>
| 10. Repetitive sentences, calls, questions, or words
| <*Answer_9167*>
| 11. Complaining, negativism, refusal to follow directions
| <*Answer_9168*>
| 12. Strange noises (weird laughter or crying)
| <*Answer_9169*>
| 13. Hiding or hoarding things
| <*Answer_9170*>
| 14. Screaming
|
| <*Answer_9171*>
|
|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.
|
| Cohen Mansfield, 1986. All rights reserved.
| Veteran: <.Patient_Name_Last_First.>
| SSN: <.Patient_SSN.>
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
|
