{"id":4387,"date":"2017-07-22T08:18:18","date_gmt":"2017-07-22T14:18:18","guid":{"rendered":"http:\/\/abclegaldocs.com\/blog-Colorado-Notary\/?p=4387"},"modified":"2023-05-27T13:59:38","modified_gmt":"2023-05-27T19:59:38","slug":"alert-and-oriented-mental-status-exam","status":"publish","type":"post","link":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/","title":{"rendered":"Alert and Oriented Mental Status Exam"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-transparent ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Alert_and_Oriented_Mental_Status_Exam\" >Alert and Oriented Mental Status Exam<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Level_of_Consciousness\" >Level of Consciousness<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Alert_and_Orientated_to_Person_Place_Time_and_Situation\" >Alert and Orientated to Person, Place, Time and Situation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Dementia\" >Dementia<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Nature_of_the_Act_Consequences\" >Nature of the Act, Consequences<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#HIPAA_Privacy_Rule\" >HIPAA Privacy Rule<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Registration_and_Recall_Memory_Test\" >Registration and Recall Memory Test<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Attention_and_Calculation_Test\" >Attention and Calculation Test<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/#Notary_Check_for_Alert_and_Oriented_Legal_Capacity\" >Notary Check for Alert and Oriented, Legal Capacity<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h1 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Alert_and_Oriented_Mental_Status_Exam\"><\/span><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/alert-and-oriented-mental-status-exam-320x200.jpg\"><img decoding=\"async\"  class=\"size-full wp-image-4391 alignleft\" src=\"data:image\/gif,GIF89a%01%00%01%00%80%00%00%00%00%00%FF%FF%FF%21%F9%04%01%00%00%00%00%2C%00%00%00%00%01%00%01%00%00%02%01D%00%3B\" data-layzr=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/alert-and-oriented-mental-status-exam-320x200.jpg\" alt=\"alert and oriented mental status exam 320x200\" width=\"320\" height=\"200\" \/><\/a>Alert and Oriented Mental Status Exam<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p style=\"text-align: justify;\">In the medical field, A&amp;Ox4, A\/Ox4 or <strong>AOx4<\/strong> means the patient is <strong>alert and oriented<\/strong> to <strong>person<\/strong>, <strong>place<\/strong>, <strong>time<\/strong>, <strong>situation<\/strong>.<\/p>\n<p style=\"text-align: justify;\">This short <strong>mental status exam<\/strong> (MSE) for level of orientation is part of a <strong>neurological exam<\/strong>. It may be used in <strong>psychology<\/strong> and <strong>medicine<\/strong> by a psychiatrist, psychologist, doctor, nurse, medical assistant, social worker or emergency medical technician (EMT).<!--more--><\/p>\n<p style=\"text-align: justify;\">Many medical offices and facilities only use the first three questions to observe <strong>AOx3<\/strong> status for person, place and time. Many medical personnel believe that alert and oriented x3 indicates a completely <strong>normal level of consciousness<\/strong> and <strong>orientation<\/strong>, indicating <strong>medical capacity<\/strong> to make decisions regarding medical treatment.<\/p>\n<p style=\"text-align: justify;\">Some facilities may use five questions, including identifying an <strong>object<\/strong>\u00a0to observe <strong>AOx5<\/strong>.<\/p>\n<p style=\"text-align: justify;\">Based on the alert and oriented mental status exam, a different <strong>course of action<\/strong> may be advised or followed.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Level_of_Consciousness\"><\/span>Level of Consciousness<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\">A patient\u2019s level of <strong>awareness<\/strong> may be categorized as:<br \/>\n1. <strong>Awake, Alert<\/strong> &#8211; eyes open, interactive, responsive<br \/>\n2. <strong>Lethargic<\/strong> &#8211; sleepy, drowsy, arousable then responsive<br \/>\n3. <strong>Obtunded<\/strong> &#8211; difficult to arouse, arousable with repeated stimulation<br \/>\n4. <strong>Stuporous<\/strong> &#8211; semi-comatose, arousable with vigorous stimulation<br \/>\n5. <strong>Comatose<\/strong> &#8211; cannot be aroused, no response, no interaction with surroundings<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Alert_and_Orientated_to_Person_Place_Time_and_Situation\"><\/span>Alert and Orientated to Person, Place, Time and Situation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\">Orientation can be determined with the following questions.<br \/>\n1. <strong>Person<\/strong>&#8211; What is your name? When is your birthday? Who is this family member\/friend\/person next to you?<br \/>\n2. <strong>Place<\/strong>&#8211; What building, floor, city, county, state are we in?<br \/>\n3. <strong>Time<\/strong>&#8211; What is the month, date, year, day of week, season?<br \/>\n4. <strong>Situation (or event)<\/strong>&#8211; Why are you here? What happened?<br \/>\n5. <strong>Object\/item<\/strong>&#8211; What is this object\/item? (a book, telephone, and penny\u00a0are commonly used)<\/p>\n<p style=\"text-align: justify;\">Ask simple <strong>open-ended questions<\/strong> that require thinking and reasoning to form an answer. Do not ask <strong>closed-ended questions<\/strong> that may be answered yes or no.<\/p>\n<p style=\"text-align: justify;\">If the signer is alert and answers all 4 questions correctly, you can make a notation of &#8220;<strong>AOx4<\/strong>&#8221; in the <strong>notary journal<\/strong>. If they cannot answer a question, make a notation such as &#8220;<strong>AOx3<\/strong>, except date&#8221; to indicate they are not aware of the current date.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Dementia\"><\/span>Dementia<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/Alzheimers-disease-brain-comparison-dementia.jpg\"><img decoding=\"async\"  class=\"alignleft size-full wp-image-4392\" src=\"data:image\/gif,GIF89a%01%00%01%00%80%00%00%00%00%00%FF%FF%FF%21%F9%04%01%00%00%00%00%2C%00%00%00%00%01%00%01%00%00%02%01D%00%3B\" data-layzr=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/Alzheimers-disease-brain-comparison-dementia.jpg\" alt=\"'s disease brain comparison dementia\" width=\"320\" height=\"145\" \/><\/a><strong>Dementia<\/strong> is a condition with deterioration in two or more areas of memory, language skills, ability to focus and pay attention, ability to reason and problem-solve, or visual perception, affecting the ability to perform everyday activities.\u00a0Mild <strong>cognitive impairment<\/strong> includes some memory or thinking difficulties, but not severe enough for a diagnosis of dementia.<\/p>\n<p style=\"text-align: justify;\">The <strong>mini mental state examination<\/strong> (<strong>MMSE<\/strong>), is a 10-minute, 30-point questionnaire, and the most commonly used test for dementia.\u00a0\u00a0A score of 24 or more (out of 30) indicates no cognitive impairment, 19-23 points mild impairment, 10-18 points moderate impairment, and 9 points or less, severe impairment. Free versions of the test are available on the internet.\u00a0 See\u00a0<strong><span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.uml.edu\/docs\/Neuropsychological%20Exam%20English_tcm18-142939.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">mini mental state examination<\/a><\/span>.<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>Orientation to person<\/strong> is the last element of orientation to be lost, usually only in <strong>severe dementia<\/strong> or in psychotic states. Orientation to <strong>time and place<\/strong> are usually lost before person orientation. An <strong>Alzheimer&#8217;s<\/strong> patient may become confused about place and time, wander away and get lost. <strong>Impairment<\/strong> in orientation and <strong>memory<\/strong> are found consistently in Alzheimer&#8217;s. Patients with other <strong>dementia<\/strong> often maintain orientation but <strong>memory<\/strong> is impaired.<\/p>\n<p style=\"text-align: justify;\">Alzheimer&#8217;s patients comprise 50% to 70% of dementia cases, followed by vascular dementia caused by <strong>stroke<\/strong> (25%), Lewy body dementia (15%), and frontotemporal dementia (2% to 5%).\u00a0Less common causes of dementia include head injury, Huntington&#8217;s disease and Parkinson&#8217;s disease dementia in about 50% to 80% of Parkinson&#8217;s patients.<\/p>\n<p style=\"text-align: justify;\">About 3% of people between the ages of 65-74 have dementia, 19% between 75 and 84 and nearly 50% of those over 85 years of age.<\/p>\n<p style=\"text-align: justify;\">In Colorado, in 2016, there were about 10,000 Alzheimer&#8217;s patients age 65-74, 28,000 patients age 75-84, and 28,000 patients age 85 or older, for a total of 67,000. The total is expected to grow to 92,000 by 2025.<\/p>\n<p style=\"text-align: justify;\">The Colorado Probate Code defines an <strong>incapacitated<\/strong> adult as an adult \u201c<em>who is\u00a0unable to effectively receive or <strong>evaluate information<\/strong> or both or make or <strong>communicate decisions<\/strong>\u00a0to such an extent that the individual lacks the ability to satisfy essential requirements\u00a0for physical health, safety, or self-care, even with appropriate and reasonably available technological\u00a0assistance.<\/em>\u201d<\/p>\n<p style=\"text-align: justify;\">A person with dementia may have a\u00a0<strong>lucid interval<\/strong>\u00a0due to medication, hydration, diet, vitamins, stimulus, and other factors,\u00a0when they can understand, make rational decisions and communicate. Different types of dementia involve different parts and functions of the brain.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Nature_of_the_Act_Consequences\"><\/span>Nature of the Act, Consequences<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\">Some <strong>law firms<\/strong> consider a score of AO3 or AO4 as likely <strong>alert and aware enough<\/strong> to show <strong>legal capacity<\/strong> to sign <strong>legal documents<\/strong>, but lower scores should be declined or rescheduled for a better time when the signer is more alert, rested or better oriented after taking medication, drinking coffee, walking or exercising. Family members may be able to recommend the best time to sign documents.<\/p>\n<p style=\"text-align: justify;\">For legal documents, the principal must <strong>understand<\/strong> the <strong>nature of the act<\/strong> and its <strong>consequences<\/strong>, at the time of execution, and must sign voluntarily. The <strong>level of capacity<\/strong> required varies by the type of document: <strong>testamentary capacity<\/strong> for a <strong><span style=\"text-decoration: underline;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/notarize-will-colorado\/\" target=\"_blank\" rel=\"noopener noreferrer\">last will<\/a><\/span><\/strong>, or\u00a0<strong>contractual capacity<\/strong> for contracts.<\/p>\n<p style=\"text-align: justify;\">Testamentary capacity requires <span style=\"text-decoration: underline;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/sound-mind-definition\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>sound mind<\/strong><\/a><\/span>\u00a0including\u00a0<strong>awareness<\/strong> of the extent of\u00a0<strong>property<\/strong> owned and the\u00a0<strong>family members<\/strong>,\u00a0including all <strong>children<\/strong> (natural objects of their bounty), the natural <strong>heirs<\/strong>. Colorado courts define sound mind as presence of the <strong>Cunningham Test<\/strong>\u00a0elements and absence of the <strong>Insane Delusion Test<\/strong> elements.<\/p>\n<p style=\"text-align: justify;\">For an <span style=\"text-decoration: underline;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/notary-certificate\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>acknowledgment<\/strong><\/a><\/span>, &#8220;acknowledged before me&#8221; means that the signer appeared before the notary, acknowledged that he\/she executed the instrument for the purposes stated therein, and by proper authority.<\/p>\n<p style=\"text-align: justify;\">If the notary has information or reason to believe the signer has a mental impairment or <strong>diminished capacity<\/strong>, the notary can ask probing questions to determine <strong>legal capacity<\/strong>.<\/p>\n<p style=\"text-align: justify;\">Has a doctor made a diagnosis that you are mentally incapacitated? Has a court made a ruling that you are mentally incapacitated?<\/p>\n<p style=\"text-align: justify;\">Are you over the age of 18? What is the <strong>title<\/strong> of this document? What is the nature and <strong>purpose<\/strong> of this document? What are the <strong>consequences<\/strong>\u00a0and effect of signing this document? [See <em>Blackmer v. Blackmer<\/em>, 525 P.2d 559 (Mont. 1974)] The notary should not probe into the private contents of the document or quiz the signer on the <strong>comprehension<\/strong> of the document.<\/p>\n<p style=\"text-align: justify;\">Is the signer acting rationally in his\/her own best interest? A <strong>delusion<\/strong> does not mean incapacity if it does not materially affect the nature and consequences of the document or transaction.<\/p>\n<p style=\"text-align: justify;\">The notary should decline to notarize if the signer does not appear to have legal capacity at the moment, or if the notary knows the person has been adjudged as mentally <strong>incapacitated<\/strong> by a court and legal capacity has not been restored.<\/p>\n<p style=\"text-align: justify;\">If there is a witness, ask the witness if he\/she believes the signer is of sound mind and appears to understand the nature and consequences of signing the document. A witness could sign a notarized affidavit.<\/p>\n<p style=\"text-align: justify;\">With permission, the transaction may be recorded on <strong>video<\/strong> for evidence of the signer&#8217;s legal capacity.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"HIPAA_Privacy_Rule\"><\/span>HIPAA Privacy Rule<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/HIPAA-logo.jpg\"><img decoding=\"async\"  class=\"alignleft size-full wp-image-4393\" src=\"data:image\/gif,GIF89a%01%00%01%00%80%00%00%00%00%00%FF%FF%FF%21%F9%04%01%00%00%00%00%2C%00%00%00%00%01%00%01%00%00%02%01D%00%3B\" data-layzr=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/HIPAA-logo.jpg\" alt=\"HIPAA logo\" width=\"150\" height=\"150\" \/><\/a>Beware of unauthorized use or disclosure of patient <strong>protected health information<\/strong> (PHI) protected by the\u00a0<strong>Health Insurance Portability and Accountability Act<\/strong> (<strong>HIPAA<\/strong>) <strong>Privacy Rule<\/strong>.<\/p>\n<p style=\"text-align: justify;\">Do not ask health care providers to disclose private\u00a0<strong>medical records<\/strong> or <strong>protected health information<\/strong> unless there is a <span style=\"text-decoration: underline;\"><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/hipaa-authorization-form\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>HIPAA release form<\/strong><\/a><\/span> authorizing you to see or use the private information. HIPAA imposes <strong>financial penalties<\/strong> for improper disclosure of private medical information.<\/p>\n<p style=\"text-align: justify;\">The <strong>HIPAA Security Rule<\/strong> requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information.<\/p>\n<p style=\"text-align: justify;\">Note: Laws vary by state. Colorado laws regarding privacy, copies and inspection of medical records are found at CRS 25-1-801. <em>Patient records in custody of health care facility<\/em>.<\/p>\n<p style=\"text-align: justify;\">If your <strong>notary journal<\/strong> is open to public inspection, do not record any <strong>protected health information<\/strong> in the journal. If the journal is not open to public inspection, if you record any protected health information, you can use a coding system to enter <strong>cipher text<\/strong>, rather than <strong>plain text<\/strong>.<\/p>\n<p style=\"text-align: justify;\">For example, instead of writing <strong>AO4<\/strong>, the entry might read 414F34, based on the Unicode character numbers, or some other coding system that you choose or create. Keep the notary journal <strong>secure<\/strong> and cover unrelated journal entries during notarization to <strong>maintain privacy<\/strong>.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Registration_and_Recall_Memory_Test\"><\/span>Registration and Recall Memory Test<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\">In addition to an alert and oriented exam, a registration and recall <strong>memory test<\/strong>\u00a0is used to assess the ability to remember information. Three words, often book, telephone, and penny, are given to the patient to remember.<\/p>\n<p style=\"text-align: justify;\">The patient is instructed to repeat the three words and told they will be asked to recall the three words again in a few minutes. Then, after 3-5 minutes involving another activity (see serial sevens test below), the patient is asked to recall the three words. One point for each correct answer.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Attention_and_Calculation_Test\"><\/span>Attention and Calculation Test<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\"><strong>Serial sevens<\/strong>, counting down from one hundred by sevens, is used to test attention and calculation ability. Five points maximum, one point for each correct answer, 100, 93, 86, 79, 72, 65.<\/p>\n<h2 style=\"text-align: justify;\"><span class=\"ez-toc-section\" id=\"Notary_Check_for_Alert_and_Oriented_Legal_Capacity\"><\/span>Notary Check for Alert and Oriented, Legal Capacity<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p style=\"text-align: justify;\"><strong>Awareness<\/strong> and <strong>orientation<\/strong> questions are especially important for a patient or signer with a head injury or brain disease, <strong>Alzheimer&#8217;s<\/strong>, <strong>stroke<\/strong>, <strong>dementia<\/strong>, or person under the influence of <strong>drugs<\/strong> or <strong>alcohol<\/strong>.<\/p>\n<p style=\"text-align: justify;\">While a <strong>notary<\/strong> is a lay person, not a medical professional, and does not make a medical diagnosis of <strong>mental competence<\/strong>, a few simple questions and observations may be used to determine <strong>awareness<\/strong> and <strong>orientation<\/strong>\u00a0and legal capacity of a signer before a legal document is signed and notarized. This demonstrates the use of <strong>reasonable care<\/strong> or a<strong> higher degree of care<\/strong> when the <strong>foreseeable risk<\/strong> is higher and the burden of taking an extra precaution is low.<\/p>\n<p style=\"text-align: justify;\">Notarizations that are completed or <strong>declined<\/strong> should be entered in the notary journal. Occasional declines are evidence the notary does not issue an automatic stamp without checking for <strong>awareness<\/strong>\u00a0and <strong>legal capacity<\/strong>.<\/p>\n<p style=\"text-align: justify;\">Ask questions in a friendly, conversational manner. Thank the person for helping.<\/p>\n<p style=\"text-align: justify;\">If the level of awareness or capacity is questionable, a <strong>mental health<\/strong> professional may be needed to test and diagnose whether the individual has adequate capacity to make legal decisions and understand what he or she is signing.<\/p>\n<p style=\"text-align: justify;\">Beware of <strong>discrimination<\/strong>.\u00a0Federal laws define a person with a <strong>disability<\/strong> as &#8220;<em>Any person who has a <strong>physical or mental impairment<\/strong> that substantially limits one or more major life activities; has a record of such impairment; or is regarded as having such an impairment.<\/em>&#8220;<\/p>\n<p style=\"text-align: justify;\"><strong>Image Credits<\/strong>:<br \/>\n1. <strong>Brain comparison<\/strong>, left normal brain vs. right brain with Alzheimer&#8217;s disease,\u00a0by derivative work: Garrondo (talk) Alzheimer&#8217;s Disease Education and Referral Center, a service of the National Institute on Aging. [Public domain], via Wikimedia Commons<br \/>\n2. <strong>HIPAA<\/strong> graphic,\u00a0U.S. Department of Health &amp; Human Services (HHS),\u00a0www.hhs.gov [Public domain]<\/p>\n<p style=\"text-align: justify;\">Visit our website for\u00a0<strong><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/mobile-notary\/\" data-slimstat-async=\"false\" data-slimstat-callback=\"false\" data-slimstat-tracking=\"false\" data-slimstat-type=\"2\" data-slimstat-clicked=\"false\">Colorado Springs Mobile Notary<\/a><\/strong>\u00a0services or\u00a0<strong><a href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/colorado-notary-training\/\" data-slimstat-async=\"false\" data-slimstat-callback=\"false\" data-slimstat-tracking=\"false\" data-slimstat-type=\"2\" data-slimstat-clicked=\"false\">Colorado Notary Training<\/a>\u00a0<\/strong>classes.<\/p>\n<p style=\"text-align: justify;\">\u00a9 Copyright 2017\u00a0 ABC Legal Docs, LLC\u00a0 All rights reserved.\u00a0 Do not copy.\u00a0 Citations welcome.\u00a0 Terms of Use apply.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Alert and Oriented Mental Status Exam In the medical field, A&amp;Ox4, A\/Ox4 or AOx4 means the patient is alert and oriented to person, place, time, situation. This short mental status exam (MSE) for level of orientation is part of a neurological exam. It may be used in psychology and medicine by a psychiatrist, psychologist, doctor, nurse, medical assistant, social worker or emergency medical technician (EMT).<\/p>\n","protected":false},"author":1,"featured_media":4391,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[8,12],"tags":[2439,324,2440,217,2443,515,2444,2448,73,143,1641,587,2447,2446,2441,2442,149,2445,329,713],"class_list":["post-4387","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-how-to","category-notary-law","tag-alert-and-oriented","tag-alzheimers","tag-aox4","tag-awareness","tag-cognitive-impairment","tag-competence","tag-contractual-capacity","tag-delusion","tag-dementia","tag-disability","tag-discrimination","tag-hipaa","tag-legal-capacity","tag-mental-health","tag-mental-status-exam","tag-mini-mental-state-examination","tag-notary-journal","tag-privacy-rule","tag-sound-mind","tag-stroke","has_thumb"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Alert and Oriented Mental Status Exam - Notary Colorado Springs<\/title>\n<meta name=\"description\" content=\"alert and oriented,AOx4,mental status exam,awareness,dementia,mini mental state examination,Alzheimer&#039;s,stroke,sound mind,HIPAA,Privacy Rule,notary journal\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alert-and-oriented-mental-status-exam\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Alert and Oriented Mental Status Exam - Notary Colorado Springs\" \/>\n<meta property=\"og:description\" content=\"alert and oriented,AOx4,mental status exam,awareness,dementia,mini mental state 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Delaware requires education for electronic\u2026","rel":"","context":"In &quot;Colorado Notary Training&quot;","block_context":{"text":"Colorado Notary Training","link":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/category\/colorado-notary-training\/"},"img":{"alt_text":"Notary Training requirements","src":"https:\/\/i0.wp.com\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/Notary-Training-requirements-320x200.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":211,"url":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/alzheimers-dementia-patient-notarization\/","url_meta":{"origin":4387,"position":5},"title":"Alzheimer&#8217;s or Dementia Patient Notarization","author":"Jerry Lucas","date":"January 23, 2014","format":false,"excerpt":"Alzheimer's or Dementia Patient Notarization A Colorado Notary must use reasonable care to determine whether a signer is aware of the purpose of the document being signed.\u00a0 When dealing with a patient that has Alzheimer's or dementia or any other illness or injury that may affect judgment or understanding, the\u2026","rel":"","context":"In &quot;Notary Law&quot;","block_context":{"text":"Notary Law","link":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/category\/notary-law\/"},"img":{"alt_text":"Colorado Notary Law","src":"https:\/\/i0.wp.com\/abclegaldocs.com\/blog-Colorado-Notary\/wp-content\/uploads\/2014\/01\/Colorado_Notary_Law_120x80.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":false,"_links":{"self":[{"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/posts\/4387","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/comments?post=4387"}],"version-history":[{"count":2,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/posts\/4387\/revisions"}],"predecessor-version":[{"id":10286,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/posts\/4387\/revisions\/10286"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/media\/4391"}],"wp:attachment":[{"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/media?parent=4387"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/categories?post=4387"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/abclegaldocs.com\/blog-Colorado-Notary\/wp-json\/wp\/v2\/tags?post=4387"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}