Assessment/Management of Dementia

GENERAL INFORMATION

Dementia                                                                                                                                      
http://consultgerirn.org/resources/geriatric_topics/
Under “Evidence-Based Geriatric Protocols and Topics”, select “Dementia”'

Excellent information and resources. Includes access to a wide variety of resources including assessment and screening tools, evidence-based practice, and topic resources.

Dementias: Hope Through Research                                                                                         
http://www.ninds.nih.gov/disorders/alzheimersdisease/detail_alzheimersdisease.htm#What Is Dementia

NIH sponsored website that provides a good overview of dementia. Includes general information about dementia including different kinds of dementia, causes, risk factors, diagnosis, treatment, prevention and research.

Stages of Dementia/Alzheimer’s Disease          
http://www.ec-online.net/Knowledge/articles/alzstages.html                                                               

Provides a good overview of the stages of dementia.

Dementia: Info and Advice for Caregiver

http://familydoctor.org/online/famdocen/home/common/brain/disorders/585.html                      

Good information for family education. Includes information on what dementia is, symptoms, treatment, causes of and treatment for agitation, hallucinations, sleep, and wandering. Also includes many links to other resource sites.

Myth Busting: Dementia and Wandering                                                                                  
http://www.rgpc.ca/best/BPC - Blogs/BP Blogger-Wandering Nov-Dec 2007.pdf                     

Features facts and fiction about wandering in a colorful, easy-to-read format.

ASSESSMENT

Dementia and Delirium Assessment Tools  
http://www.healthcare.uiowa.edu/igec/tools/categoryMenu.asp?categoryID=1                               

Offers access to the Clock Drawing Test, Confusion Assessment Method, Short Portable Mental Status Questionnaire, and Time and Change Test.

The Mini Cognitive Exam
                                                                                
http://www.nicheprogram.org/niche_encyclopedia-assessment-mini_cog                                            

The Mini-Cog in a tool that can be used to detect dementia quickly and easily in various settings, either during routine visits or hospitalization. This site features information about the Mini-Cog and how to administer it. Also features links to other pages related to the Mini-Cog, Alzheimer’s screening tests, geriatric care and dementia.

SLUMS (St. Louis University Mental Status Exam)
http://medschool.slu.edu/agingsuccessfully/pdfsurveys/slumsexam_05.pdf
Developed to detect for mild cognitive impairment.

How To Try This: The Mini-Cog . American Journal of Nursing, 107(12), 62-71) Features more in-depth information about the mini-cog including its uses, administration, interpretation of results, cultural considerations, and communication of results.
                                 
Mini Cognitive Instrument: http://consultgerirn.org/uploads/File/trythis/issue03.pdf
Scroll down to the “General Assessment Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to issue 3.

This document includes information on Mini-Cog administration and scoring. In addition to the assessment tool, this document also includes information on the why the tool is important, target population, validity and reliability, and strengths and limitations.

Recognition of Dementia in Hospitalized Older Adults                                                         
http://consultgerirn.org/uploads/File/trythis/communication.pdf

Scroll down to the “Dementia Series” box. In the upper right hand corner, click on “Click to view”. Scroll down to “D5: Recognition of Dementia in Hospitalized Older Adults”.

Features assessment tool and includes information on why it is important, target population, best practices, and what to do when there is no prior diagnosis of dementia is reported.

Video: http://consultgerirn.org/resources/media/?vid_id=4361882#player_container

Demonstrates the use of the four recommended approaches to recognizing dementia in hospitalized older adults.

Article: http://nursing.ceconnection.com/nu/ovidfiles/00000446-200801000-00028.pdf
(Maslow, K., & Mezey, M. (2008). How To Try This: Recognition of Dementia in Hospitalized Older Adults. American Journal of Nursing, 108(1), 40-49.)

Features overview of dementia is hospitalized patients, approaches to recognizing dementia, administering the “Try This” approach, scoring and interpreting results, challenges, and communicating the findings.

Assessing Pain in Persons with Dementia                                                                                 

Assessment Tool: http://consultgerirn.org/resources/?tt_request=assessingPain.pdf 
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D2: Assessing Pain in Persons with Dementia”.

Features assessment tool for pain in advanced dementia (PAINAD) and includes information on why it is important, target population, best tools, validity and reliability, strengths and limitations, and barriers to pain management in older adults with dementia.

Article: http://nursing.ceconnection.com/nu/ovidfiles/00000446-200807000-00030.pdf
(Horgas, A., & Miller, L. (2008). Pain Assessment in People with Dementia. American Journal of Nursing, 109(7), 62-70.)

Describes the pain assessment in advanced dementia (PAINAD) scale, administering the PAINAD scale, scoring and interpreting the results, challenges of using the PAINAD and communicating the results.

Video:   http://consultgerirn.org/resources/media/?vid_id=4669429#player_container
Video features information on pain assessment in older adults.


Assessment of Cognitive Impairment: Executive Function
                                                 

Assessment Tool: http://consultgerirn.org/uploads/File/trythis/issue_d3.pdf   
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D3: Brief Evaluation of Executive Dysfunction”.

This resource offers three screening tests of executive function including cognitive flexibility, concept formation, and self-monitoring. The tests can be administered in both hospital and ambulatory care settings.

Article:   http://nursing.ceconnection.com/nu/ovidfiles/00000446-200812000-00030.pdf
Kennedy, G. J., & Smyth, C. A. (2008). Screening Older Adults for Executive Dysfunction. American Journal of Nursing, 108(12), 62-71.)

Features information on the importance of screening for executive dysfunction, administering brief tests of executive dysfunction, scoring and interpretation, communicating the results and challenges.

Video: http://consultgerirn.org/resources/media/?vid_id=5004177#player_container

Decision Making in Older Adults with Dementia

Assessment Tool: http://consultgerirn.org/uploads/File/trythis/issue_d9.pdf
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D9: Decision Making in Older Adults with Dementia”.

Document provides guidelines for evaluating decision making capacity. Includes information on why it is important, best practices, target population, and guiding concepts.

Detecting Depression in Older Adults with Dementia                                                            
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891505/                                                                      
Clinical practice guideline developed through the University of Iowa Gerontological Nursing Interventions Research Center.

NURSING CARE

Eating and Feeding Issues in Older Adults with Dementia                                                                
Assessment Tool: http://consultgerirn.org/resources/?tt_request=dementia.pdf

Part I Assessment:
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”.  Scroll down to “D11.1: Eating and Feeding Issues in Older Adults with Dementia. Part I: Assessment”.  

Includes the Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q), which helps to determine how much assistance a person with dementia needs at a meal. Also includes other assessment guidelines.

Article: http://nursing.ceconnection.com/nu/ovidfiles/00000446-200808000-00025.pdf
(Stockdell, R., & Amella, E. J. (2008). How to Try This: The Edinburgh Feeding Evaluation in Dementia Scale: Determining how much help people with dementia need at mealtime. American Journal of Nursing, 108(8), 46-54.)

Includes information on the EdFED-Q including administration, scoring and interpreting results, other considerations, communicating the results, and why it is important to check for eating and eating problems in older adults.

Video: http://consultgerirn.org/resources/media/?vid_id=4902587#player_container

Part II Interventions: 
Assessment Tool: http://consultgerirn.org/resources/?tt_request=dementia.pdf
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D11.2: Eating and Feeding Issues in Older Adults with Dementia: Part II (interventions)

Provides best practices for assessment and strategies to address eating and feeding issues for older adults with dementia.

Behaviors Associated with Dementia                                                                                       
http://www.nursingcenter.com/lnc/pdf?AID=591295&an=00000446-200507000-00028&Journal_ID=54030&Issue_ID=591242
 
(Smith, M., & Buckwalter, K. (2005). Behaviors Associated with Dementia. American Journal of Nursing, 105(7), 40-52.)

Excellent article published in the July 2005 issue of the American Journal of Nursing. Focus of article is the assessment and management of persons with dementia exhibiting behavioral symptoms.Includes information on late-life cognitive impairment, common types of dementia, behavioral symptoms of dementia, and the language of dementia care.

The Bathing of Older Adults with Dementia                                                                        
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=637530

(Rader, J., Barrick, A., Hoeffer, B., Sloane, P. D., McKenzie, D., Talerico, K. A., & Glover, J. U. (2006). The Bathing of Older Adults with Dementia. American Journal of Nursing, 106(4), 40-48.)

Excellent article published in the April 2006 issue of the American Journal of Nursing. Focus of article is strategies to reduce/eliminate agitated behaviors when bathing persons who have dementia. Includes information in current bathing practices, clinical trial, practical approaches, and recommendations and resources.

Communication Difficulties: Assessment and Interventions in Hospitalized Older Adults with Dementia                         
                                                                                                      
Assessment Tool:
http://consultgerirn.org/resources/?tt_request=issue_d7.pdf
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D7: Communication Difficulties: Assessment and Interventions”.

Features tools to assess language deficits (receptive and expressive abilities) and facilitate communication. Includes information on why this is important, best practices, and target population.

Article:  http://www.nursingcenter.com/library/journalarticle.asp?article_id=775983
(Miller, C. (2008). Communication Difficulties in Hospitalized Older Adults with Dementia: Try these techniques to make communicating with patients easier and more effective. American Journal of Nursing, 108(3), 58-66.)

Features information on how to use the assessment tool including assessing receptive and expressive abilities, challenges, and communicating the results.  [Note: this article is not free, however you may be able to access it through your library].

Video: http://consultgerirn.org/resources/media/?vid_id=4610524#player_container

Best practices and guidelines for effective communication with persons with dementia when hospitalized.

Working with Families of Hospitalized Persons with Dementia
                                        

Assessment Tool: http://consultgerirn.org/uploads/File/trythis/issue_d10.pdf
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D10: Working with Families of Hospitalized Older Adults with Dementia”.                                                                                             

Provides an information sheet that can be filled out by family members of care givers and that provides  important information about the patient to their hospital care team. Also includes information on why this is important, target population and best practices.

Article:http://nursing.ceconnection.com/nu/ovidfiles/00000446-200810000-00026.pdf;jsessionid=95A4D7974174915031AD640D04003C8D
(Bradway, C., & Hirschman, K. B. (2008). How to Try This: Working with Families of Hospitalized Older Adults with Dementia. American Journal of Nursing, 108(10), 52-60.)

Provides information about working with families, using the form, scoring and interpretation, and communicating the results.

Video: http://consultgerirn.org/resources/media/?vid_id=5003780#player_container

Wandering in the Hospitalized Older Adult                                                                      

Assessment Tool: http://consultgerirn.org/resources/?tt_request=issue_d6.pdf
Scroll down to the “Dementia Series” box. In the upper right hand corner, click on “Click to view”. Scroll down to “D6: Wandering in the Hospitalized Older Adult”.

Provides a multitude of information and approaches to preventing and managing wandering in hospitalized older adults. Topics include identifying risk factors for wandering, providing appropriate supervision to patients at risk, reducing environmental triggers for wandering, nursing interventions that may be helpful, and information on developing protocols for finding patients that may be lost inside or outside of the hospital.

Article: http://www.nursingcenter.com/library/journalarticle.asp?article_id=818882
(Rowe, M. (2008). Wandering in Hospitalized Older Adults: Identifying risk is the first step in this approach to preventing wandering in patients with dementia. American Journal of Nursing, 108(10), 62-70.)

Features information on approaches to preventing and managing wandering in, accurate assessment, supervision, rapid response, challenges, and communicating about wandering.

Video:
Video on same subject.
http://consultgerirn.org/resources/media/?vid_id=5003810#player_container

Avoiding Restraints in Patients with Dementia

Assessment Tool: http://consultgerirn.org/uploads/File/trythis/dementia.pdf 
Scroll down to the “Dementia Series” box. In the upper right hand corner, click on “Click to view”. Scroll down to “D1: Avoiding Restraints in Patients with Dementia”.

Tips are provided by the authors for assessing patient behaviors and the risks of using restraints. Useful interventions to respond to patient behaviors are also provided.

Article:  http://www.nursingcenter.com/library/journalarticle.asp?article_id=775972 
(Evans, L. K., & Cotter, V. T. (2008). Avoiding Restraints in Patients with Dementia: Understanding, prevention, and management are the keys. American Journal of Nursing, 108(3), 40-49.)


Features information on approaches to avoiding restraint use, managing risk, strategies to east and comfort patients, and reasons why restraint use in patients with dementia is a problem.

Video: http://consultgerirn.org/resources/media/?vid_id=4475795#player_container

Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes
http://www.alz.org professionals_and_researchers_dementia_care_practice_recommendations.asp

Very important resource developed by the Alzheimer’s Association on evidence-based dementia care practices. Phases 1 and 2 address fundamentals of dementia care and Phase 3 addresses end-of-life care for persons with dementia. Phase 4 addresses dementia care practice recommendations for professionals working in a home setting.

Individualized Music for Elders with Dementia                                  
http://www.ncbi.nlm.nih.gov/pubmed/20536115

Clinical practice guideline developed through the University of Iowa Gerontological Nursing Interventions Research Center.

APA Practice Guidelines for the Treatment of Alzheimer's Disease and Other Dementias
http://www.psychiatryonline.com/pracGuide/pracGuideTopic_3.aspx                                    

Provides evidence-based guidelines for the treatment of dementia.

PROFESSIONAL ORGANIZATIONS                                                                                                

National Council of Certified Dementia Practitioners (NCCDP)

http://www.nccdp.org/                                                                                                                      
NCCDP was formed to promote standards of excellence in dementia and Alzheimer's education to professionals and other caregivers who provide services to dementia clients. Includes information on services, certification, membership, courses, and seminars. Also provides access to a staff education tool kit.

ALZHEIMER’S

GENERAL INFORMATION

Alzheimer's Disease: Unraveling the Mystery    
http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-unraveling-mystery

This document explains was Alzheimer’s Disease is, what happens to the brain, current areas of research, and improved support for families and caregivers.

Alzheimer's Disease and Genetics                                                                                                       
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=679837

(Schutte, D. L. (2006). Alzheimer Disease and Genetics: Anticipating the Questions. American Journal of Nursing, 106(12), 40-47.)

Features a clinical overview of Alzheimer’s Disease, causes, genetics, and questions, needs and guidance that are likely to arise as more information about genetics and testing is discovered. 

CAREGIVER RESOURCES

Caring for a Person with Alzheimer's                                                                                      
http://www.alzheimersdisease.com/index.jsp?checked=y                                                                  

Good website for information that can be used by family members who care for persons with Alzheimer's disease. Includes general information about the disease as well and information about caring for an Alzheimer’s patient and Alzheimer’s caregiver support.

Caring for a Person with Alzheimer’s Disease: Your Easy-to-Use Guide from the National Institute on Aging
http://www.nia.nih.gov/alzheimers/publication/caring-person-alzheimers-disease

This document includes information on understanding Alzheimer’s Disease, (AD) caring for a person with AD, caring for yourself, finding help, the medical side of AD, and coping with the late stages of AD.

The Best Friends Approach
http://www.bestfriendsapproach.com   

Provides information on the Best Friends™model of dementia care, additional resources about the model, and resources related to dementia Alzheimer’s Disease in general.

Coach Broyles’ Playbook for Alzheimer’s Caregivers: A Practical Tips Guide
http://alzheimersplaybook.com/

Created through collaboration between professionals and experiences caregivers, the playbook contains useful information to help caregivers and health care providers care for individuals with Alzheimer’s. Includes information on pacing, late afternoon behavior, refusing care, using the bathroom, home safety, dressing, wandering, communication, eating and survival tips. Playbook is available for free download.

Therapeutic Activity Kits                                                                                                    
Assessment Tool: http://consultgerirn.org/uploads/File/trythis/theraAct.pdf
Scroll down to the “Dementia Series” box. In the upper righthand corner, click on “Click to view”. Scroll down to “D4: Therapeutic Activity Kits”.

Features a list of activity kits that can be assembled and used to provide cognitive stimulation and activities for older adults with cognitive impairments.

Legal and Financial Planning for People with Alzheimer’s Disease
http://www.nia.nih.gov/alzheimers/publication/legal-and-financial-planning-people-alzheimers-disease-fact-sheet

Provides specific information about legal and financial planning for people with Alzheimer’s Disease. Includes information on legal, financial, and health care planning documents; advance directives for health care for health care, financial and estate management; who can help with planning; and additional planning advice.

OTHER RESOURCES

National Institute on Aging - Alzheimer’s Disease Publications                                                                                       
http://newcart.niapublications.org/shopdisplayproducts.aspx?id=46&cat=Alzheimer%27s+Disease+Information                                                                                                                     
Offers access to the full library of NIA publications on Alzheimer’s Disease. Allows you to search for, order, or read documents online.

HBO Alzheimer’s Project

http://www.hbo.com/alzheimers/

This series takes a look at the scientific research and discoveries that are being made regarding Alzheimer’s, and the effect the disease has on families and patients. The site features a four-part documentary series, 15 short supplemental films, a robust website, and a nationwide community-based information and outreach campaign.

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  • Last modified on May 1, 2014