Empowering occupational therapy practitioners with a playbook of functional tasks to use with their geriatric clients

Occupation-Based Assessment: Medi-Cog

Occupation-Based Assessment: Medi-Cog

I’m always looking for an occupation-based assessment that I can use to evaluate cognitive skills. As part of my OTD research project involving older adults with mild-moderate cognitive decline, I found a new assessment that I wanted to share! One of the things that I love about this assessment is that it is a formal way to evaluate performance on a medication management task, which is a vital skills for my clients as they transition home.

The assessment is called the Medi-Cog and it is a combination off the Mini-Cog and a medication transfer task. The original Medi-Cog included a paper and pencil version of the transfer task but I found a research study published early this year that actually used pills (beads), pill bottles, and a pill sorter.

Clients can earn up to 10 points on the assessment, with a score of 8 points or less indicating deficits.

A kit can be assembled with a pill sorter, pill bottles, beads, and labels.


Five points can be earned on the Mini-Cog portion, which includes clock drawing and a three item recall task. Scoring information can be found here.

Medication Transfer

The other 5 points come from the medication transfer task. The client is instructed to sort the pills into the correct compartments and the therapist demonstrates with an example bottle (“Take one tablet every day at bedtime.”). The instructions for the other bottles are:

  1. “Take one tablet every day in the morning.”
  2. “Take one tablet 3 times daily with meals.”
  3. “Take two tablets M-W-F in the evening.”
  4. Take one-half tablet on Saturday at bedtime.”

The client gets 1 point for each of the instructions they follow correctly. They also get a point for correctly answering the question “How many pills total are in the pill box for the entire day of Saturday?”

If you are looking for an occupation-based assessment for your clients with mild-moderate cognitive impairment, give this a try!

4 thoughts on “Occupation-Based Assessment: Medi-Cog

  1. I’ve done something very similar to this before and I might suggest adding a pill bottle that simulates an antibiotic and one for PRN meds. These can be a bit more challenging to add to the dosettes.

    1. If you are using the med kit for practice, that’s a great idea! These instructions are specifically to make a kit that works to administer the Medi-Cog, which is a standardized assessment.

  2. Using beads, How does it work for the 4th medication that says to take one-half pill? Just assume that the pills would already be in half from the pharmacy so the beads represent half a pill?

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