Table 4.

Group criteria guidelines

	Low Needs	Moderate Needs	High Needs	Refusal
Cognitive Functioning	Normal to mildly impaired cognitive function	Moderately impaired cognitive functioning	Severely impaired cognitive functioning	Unknown cognitive functioning Only completing an interview prior to refusal; only completed 1 test, then refusing all else Failed validity testing; testing results not believed accurate due to lack of cooperation and inconsistent and intermittently insufficient test taking effort Cooperation clearly limited accurate evaluation of cognitive status
Cognitive Functioning Descriptor Examples	Normal cognitive status, isolated mild retrieval based memory dysfunction, slowed processing speed, mild working memory impairment	Moderate attentional, executive, memory, language impairment	Severe attentional, executive, memory, or language impairment Global cognitive impairment
Knowledge of general health & safety concepts	Intact knowledge of general health and safety concepts	Questionable knowledge of general health and safety concepts	Poor knowledge of general health and safety concepts
Ability to Manage Medical Conditions	Deficits not expected to significantly interfere with ability to manage own medical conditions	Deficits expected to interfere with ability to manage medical conditions upon discharge	Deficits expected to interfere with ability to manage medical conditions and general safety upon discharge
Example of Diagnosis	No diagnosis/normal cognitive status for age, MCI (e.g MCI due to cerebrovascular disease)	Resolving encephalopathy, suspected early dementia, major neurocognitive disorder of mild or moderate severity	Likely severe major neurocognitive disorder, likely advanced dementia
Capacity Determination	Retained capacity for dispositional decisions	With or without capacity for dispositional decisions	Without capacity for dispositional decisions	Capacity deferred to medical ethics/legal
Level of Support Recommendation	No to minimal oversight recommended Able to care for self independently from a cognitive standpoint, or only brief weekly check-ins with family/nurse Commonly recommend independent compensatory aids such as use of an appointment book, pill box, etc.	Significant daily assistance required for medical management Assisted living facility, daily family help, paid help 3–4hrs/day 5 days week, Daily assistance with meals, medications	24/7 supervisory care required for medical management as well as general health and safety 24/7 family assistance, skilled nursing facility, locked dementia unit	No recommendation provided
Additional Information	Driving restrictions, or minor assistance needed due to physical limitations were not contraindications to low needs group membership	Could not go home and live independently Did not require full time 24/7 supervisory care		In rare cases, gross behavioral disturbance or obscenity with examiner; unwilling/unable to engage in meaningful exchange rendering accurate assessment of cognitive status impossible

Note. These criteria and examples are based on results as stated in archival neuropsychological reports. The examiners did not retrospectively re-analyze or re-interpret individual aspects of archival clinical data.