What factors may be playing a role in the decreased cognitive function?
A better understanding of her cognitive status would be critical for discharge planning. She requires a complete neurological and neuropsychiatric evaluation to both assess her cognitive capacity as well as to determine her functional status. An occupational therapy consult might also be considered to assess her ability to care for herself. This might be required if long-term placement is contemplated. IQ measured by Wechsler scale reveals normal verbal performance (105) but severely impaired on Freedom-from-distractibility and Performance scales, as well as markedly slowed processing. This is consistent with an alcoholic dementia. Since there is a good possibility that the patient may regain some cognitive function over the next 6-12 months, she is discharged to a nursing home, and arrangements are made for an alcohol counselor to visit her. She will be followed by a neurologist. Note: This patient was almost discharged back to her home. In alcoholic dementia, the relative preservatio
