We frequently have to decide if an elderly patient has an altered mental status. This can be a bit tricky because the patient might be a little “off” at baseline so sometimes, we have to try a little bit harder to determine if the patient is altered or not.
The other night, the intern (doctor in training) told me an eighty-year-old woman was confused because she was not able to give the exact date. After meeting her, I asked her if she knew where she was and she named, exactly, our hospital.
I asked her if she knew the date. She said, “No,” without even trying. When I pressed her, she gave the year, off by only one.
I then asked her who was the President of the United States. “Obama,” she answered confidently.
“Who is going to be the president next year?” I then asked.
“I have no idea.”
Well, who are you going to vote for, Trump or Clinton?”
“Trump.” Again, with confidence.
“You are the first person I have ever met who supports Trump. Why do you think he would make a good president?”
“Because he is very rich and has a beautiful wife.”
Since my purpose was not to delve into her politics, I stopped the interview there. If she knew those two facts about the man running for president, it was hard for me to believe she might have any significant confusion.
Oh what a great story. Does anyone really know what the date is?
Oh, yes. Most people know for sure. A lot are close enough to pass. Only a few people really have no idea what the date is.