The Psychiatric and Cognitive Mental Status Examination in the Medical-Legal Context

Abstract

This chapter provides an introduction to and overview of psychiatric and cognitive mental status examination in older adults, particularly within a medical-legal context. A methodical approach to the mental status examination involves assessment of a range of areas, including behavior, alertness, mood state, affect, thought content and process, sensory input and perception, symptom experience and safety variables, and cognitive domains including attention, language, visuospatial, memory and executive cognitive functions. This assessment can be critical in a variety of forensic contexts involving the elderly, including civil commitment, different forms of capacity, end-of-life decision making, assisting in the determination of safe or unsafe driving, risk of victimization and abuse, criminal competency and responsibility evaluations, and need for assisted and structured living. Rating scales and tools can augment, but not replace, the examination.