How to Interpret BIMS Results: A Guide for Non-Healthcare Professionals

For Families and Caregivers: Understanding What BIMS Scores Mean and What to Do Next

Caring for a loved one experiencing memory loss or confusion can be overwhelming. If you’ve recently heard about the Brief Interview for Mental Status (BIMS) as part of your loved one’s health assessment, you may be wondering what it means and how you can use the results to support their care.

This guide will break down the BIMS test in simple terms, explain what different scores indicate, and offer practical steps to help you move forward if your loved one scores low.

What Is the BIMS Test?

The Brief Interview for Mental Status (BIMS) is a quick screening tool used by healthcare providers—particularly in nursing homes, rehab centers, and hospitals—to evaluate a person’s cognitive function, which includes memory, orientation, and ability to make simple decisions.

It’s typically administered to older adults, especially during Medicare assessments in long-term care facilities.

Key Facts About BIMS:

  • It usually takes less than 10 minutes to complete.

  • No medical equipment is needed—just a brief interview.

  • It’s designed for people who are alert enough to answer basic questions.

  • The total score ranges from 0 to 15, with higher scores indicating better cognitive functioning.

What Does the BIMS Test Measure?

The BIMS is made up of three main components:

  1. Immediate Recall:
    The person is asked to remember and repeat three simple words (like “sock, blue, bed”).

  2. Temporal Orientation:
    Questions about the year, month, and day of the week assess whether the person knows the current time and date.

  3. Delayed Recall:
    After a short break, the person is asked to recall the same three words from the beginning of the test.

Each section is scored, and the points are added together to give a total score out of 15.

Understanding BIMS Scores

Now let’s decode what those numbers mean for your loved one:

🔵 Score: 13–15

Interpretation: Intact cognition

  • Your loved one is likely functioning normally in terms of memory and orientation.

  • They’re able to remember words, tell you the date, and make decisions.

  • No significant cognitive impairment was observed.

What You Can Do:

  • Continue with regular check-ins and healthy habits.

  • Keep engaging your loved one in conversations, games, reading, or light problem-solving tasks to maintain their mental sharpness.

  • Be mindful of any sudden changes in behavior, confusion, or memory.

🟡 Score: 8–12

Interpretation: Moderate cognitive impairment

  • This score suggests some memory problems or disorientation.

  • Your loved one might forget things more often, get dates mixed up, or seem confused about daily tasks.

  • They may still be able to make some decisions, but might need help with complex ones.

What You Can Do:

  • Start monitoring more closely. Take note of whether your loved one is forgetting to eat, take medications, or pay bills.

  • Encourage them to use memory aids like calendars, sticky notes, medication reminders, or digital assistants (like Alexa or Google Home).

  • Consider having someone check in daily or hiring part-time help.

  • Start a conversation with their primary care doctor about the results and what next steps are appropriate.

  • Review legal documents (power of attorney, healthcare proxy, etc.) while your loved one can still participate in decision-making.

🔴 Score: 0–7

Interpretation: Severe cognitive impairment

  • This is a strong indicator that your loved one is struggling significantly with memory and orientation.

  • They may not know the year, may not remember simple words, and may need help with most or all daily activities.

  • This score often points to conditions like dementia, Alzheimer’s disease, or the effects of a stroke or brain injury.

What You Can Do:

  • Don’t panic, but act promptly. Schedule a full cognitive and neurological evaluation.

  • Ensure your loved one’s safety: Are they at risk of falling, wandering, or leaving the stove on?

  • Evaluate whether it’s time for more structured support, such as in-home care, adult day care, or a memory care facility.

  • Involve family members in planning. Set up a care team with professionals like doctors, social workers, and geriatric care managers.

  • Begin or update legal and financial planning (living wills, guardianship, etc.).

What a BIMS Score Doesn’t Tell You

It’s important to understand that while the BIMS is useful, it’s not a diagnosis. A low score doesn’t confirm Alzheimer’s or any specific condition. It’s just a flag that further evaluation is needed.

Think of BIMS as a thermometer for brain health. If the temperature is high (or in this case, the score is low), it signals that something might be wrong—but you’ll still need a doctor to diagnose the cause.

Frequently Asked Questions

🤔 Why was my loved one given the BIMS?

Healthcare providers use it routinely in facilities to assess cognitive status, especially when someone is admitted, discharged, or reassessed periodically.

🧠 Can someone “fail” the BIMS?

There’s no “pass” or “fail.” It’s not a school test—it’s a tool to help caregivers and professionals understand where someone needs support.

🔄 Can BIMS scores change over time?

Yes! BIMS scores can fluctuate due to:

  • Illness or infection (especially urinary tract infections in older adults)

  • Medication side effects

  • Depression or emotional distress

  • Fatigue or dehydration

  • Recovery from injury or surgery

That’s why it’s essential to repeat the test periodically or after changes in health.

Actionable Steps if a Low Score Is Identified

Here’s what to do if your loved one scores below 13 on the BIMS:

✅ 1. Schedule a Medical Evaluation

Talk to their primary care doctor or a neurologist. Ask for:

  • A comprehensive cognitive assessment (like the MoCA or MMSE)

  • Blood tests to rule out vitamin deficiencies, thyroid issues, infections

  • Brain imaging (like a CT or MRI) if appropriate

✅ 2. Ensure Daily Safety

  • Check for fall risks in the home (loose rugs, poor lighting)

  • Consider installing stove shut-off timers or medication dispensers

  • Create a daily routine to reduce confusion and anxiety

✅ 3. Start a Care Plan

Even if it’s early, planning ahead is critical:

  • Discuss goals of care with your loved one while they can still participate

  • Assign medical and financial powers of attorney

  • Create a list of contacts: doctors, pharmacy, emergency contacts

✅ 4. Look Into Support Services

  • In-home care: For help with bathing, meals, or medication

  • Adult day programs: For socialization and structured activities

  • Respite care: Temporary care so you can take a break

✅ 5. Educate Yourself

Learn more about cognitive conditions like:

  • Dementia

  • Alzheimer’s

  • Vascular cognitive impairment

  • Delirium (which can sometimes mimic dementia but is treatable)

Local Alzheimer’s associations or aging services often offer free classes, support groups, and resource guides.

Tips for Supporting a Loved One With Cognitive Decline

  • Be patient: Your loved one isn’t “acting difficult”—they’re struggling.

  • Use simple language: Break down tasks or questions into small steps.

  • Keep routines: Predictability reduces anxiety.

  • Label things: Put signs on cabinets, bathrooms, or drawers.

  • Celebrate small wins: Focus on what they can still do.

When to Consider Professional Help

Sometimes the best care means bringing in professionals. Here are signs that extra help may be needed:

  • Your loved one is forgetting to eat or take medications

  • You’re feeling overwhelmed, angry, or burnt out

  • They’re getting lost, even in familiar places

  • They’re acting aggressively or very withdrawn

  • They’ve wandered away or had a fall recently

A geriatric care manager or aging life care specialist can help create a long-term plan tailored to your loved one’s needs.

Conclusion: BIMS Is a Starting Point, Not the End

The BIMS test is just the beginning of understanding your loved one’s cognitive health. Whether the score is high, moderate, or low, what matters most is how you respond—with love, preparation, and support.

Knowledge is power, especially when you’re navigating memory loss and aging. Use BIMS as a conversation starter—not a cause for panic. When you know what the numbers mean, you can take meaningful, compassionate steps toward the best possible care for your loved one.