Assessment and Staging of Care for People with Dementia

2019 ◽  
Author(s):  
Maya Semrau ◽  
Alistair Burns ◽  
Antonio Lobo ◽  
Marcel Olde Rikkert ◽  
Philippe Robert ◽  
...  
Keyword(s):  
Integrated Assessment ◽  
Case Histories ◽  
People With Dementia ◽  
Severity Of Dementia ◽  
The Ideal

Assessment and Staging of Care for Dementia: The IDEAL schedule and its user manual gives a detailed overview of the International Schedule for the Integrated Assessment and Staging of Care for Dementia (IDEAL schedule) and provides all information that is needed when learning how to use the schedule and when using it. This includes details on the aims of the schedule; a description of how the schedule was developed and tested; instructions on how to use the schedule; the IDEAL schedule itself; the glossary of terms used in the schedule; and suggestions about the interventions that are recommended for consideration at different stages of severity of dementia. The book also includes four case histories, which are recommended for use when training in the use of the schedule.

Case descriptions for use when training users of the IDEAL schedule

2019 ◽  
pp. 63-76
Author(s):  
Maya Semrau ◽  
Alistair Burns ◽  
Antonio Lobo ◽  
Marcel Olde Rikkert ◽  
Philippe Robert ◽  
...  
Keyword(s):  
Integrated Assessment ◽  
Case Histories ◽  
Local Case ◽  
Different Types ◽  
Severity Levels ◽  
The Ideal

This chapter provides four case histories that can be used in the training of future users of the International Schedule for the Integrated Assessment and Staging of Care for Dementia (IDEAL schedule) and its accompanying ‘Menu of care options’. The case histories describe patients with different types and severity levels of dementia and have been written in a manner that makes them understandable in different settings or countries, as well as having been shown to be useful in the training of users of the schedule in different countries. Ratings for the case histories are provided according to the seven dimensions of the IDEAL schedule, with the consequent links to the ‘Menu of care options’. The chapter also includes suggestions about the development of local case histories typical for the setting in which the schedule will be used when training users in that setting.

How was the IDEAL schedule developed and tested?

2019 ◽  
pp. 3-6
Author(s):  
Maya Semrau ◽  
Alistair Burns ◽  
Antonio Lobo ◽  
Marcel Olde Rikkert ◽  
Philippe Robert ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pilot Study ◽  
Integrated Assessment ◽  
Large Scale ◽  
Developmental Stages ◽  
Process Of Care ◽  
Rater Reliability ◽  
Validity Testing ◽  
People With Dementia ◽  
The Ideal

This chapter provides information on how the International Schedule for the Integrated Assessment and Staging of Care for Dementia (IDEAL schedule) was developed and tested. It includes information on the three developmental stages of the IDEAL schedule: 1) a series of focus groups, which involved convening stakeholders who were engaged in the process of care for people with dementia to assess the need for a new dementia staging schedule, and to identify the ideal design, necessary items, and characteristics for such a staging schedule; 2) a pilot study with the draft schedule and using case histories to assess inter-rater reliability of assessments obtained using the schedule; and 3) a large-scale cross-country field study to test the schedule’s inter-rater reliability when used to assess patients in clinical practice. Information about the feasibility/acceptability and validity testing of the IDEAL schedule is also included in this chapter.

The aims of the IDEAL schedule

2019 ◽  
pp. 1-2
Author(s):  
Maya Semrau ◽  
Alistair Burns ◽  
Antonio Lobo ◽  
Marcel Olde Rikkert ◽  
Philippe Robert ◽  
...  
Keyword(s):  
Social Support ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Integrated Assessment ◽  
Psychological Symptoms ◽  
Clinical Staging ◽  
Behavioural And Psychological Symptoms ◽  
Severity Of Dementia ◽  
Function Information ◽  
The Ideal

This chapter provides an overview of the purposes of the International Schedule for the Integrated Assessment and Staging of Care for Dementia (IDEAL schedule) and its user manual. The IDEAL user manual provides information that is needed when learning how to use the IDEAL schedule. The schedule is a global clinical staging schedule for dementia, which allows an assessment of a person across seven dimensions (activities of daily living, physical health, cognitive functioning, behavioural and psychological symptoms, social support, informal care, and formal professional care), and provides ability-to-function information as well as suggestions concerning care elements corresponding to the level of impairments of function. Attached to the IDEAL schedule is a ‘Menu of care options’ with recommendations for interventions for different stages of severity of dementia, as measured by the IDEAL schedule.

scholarly journals Impact of Social Isolation on People with Dementia and Their Family Caregivers

2021 ◽  
pp. 1-11
Author(s):  
Lílian Viana dos Santos Azevedo ◽  
Ismael Luis Calandri ◽  
Andrea Slachevsky ◽  
Héctor Gastón Graviotto ◽  
Maria Carolina Santos Vieira ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Social Isolation ◽  
Clinical Symptoms ◽  
Memory Function ◽  
South American ◽  
Severe Dementia ◽  
Dementia Caregivers ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Severity Of Dementia

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.

scholarly journals What Are the Benefits of Pet Ownership and Care Among People With Mild-to-Moderate Dementia? Findings From the IDEAL programme

2020 ◽  
pp. 073346482096261
Author(s):  
Carol Opdebeeck ◽  
Michael A. Katsaris ◽  
Anthony Martyr ◽  
Ruth A. Lamont ◽  
James A. Pickett ◽  
...  
Keyword(s):  
Positive Outcomes ◽  
Pet Ownership ◽  
Active Life ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Self Reports ◽  
Key Factor ◽  
Person With Dementia ◽  
The Ideal

Pet ownership has been associated with positive outcomes in many populations, yet the associations with physical and psychological wellbeing in people with dementia remain unclear. The current study used baseline data from 1,542 people living at home with mild-to-moderate dementia from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme. Regression analyses investigated associations of pet ownership and pet care with self-reports of walking, loneliness, depression, and quality of life (QoL). After adjusting for covariates, having any pet was associated with higher likelihood of walking over 3 hr in the last week. Those with a dog and who were involved in its care were less likely to be lonely than those with no dog. Having any pet but no involvement in its care was associated with increased depression and decreased QoL compared with those without a pet. The key factor in the associations was involvement in the care of the pet by the person with dementia.

Group activity with Paro in nursing homes: systematic investigation of behaviors in participants

2016 ◽  
Vol 28 (8) ◽  
pp. 1345-1354 ◽  
Author(s):  
Nina Jøranson ◽  
Ingeborg Pedersen ◽  
Anne Marie Mork Rokstad ◽  
Geir Aamodt ◽  
Christine Olsen ◽  
...  
Keyword(s):  
Social Interactions ◽  
Systematic Investigation ◽  
Group Activity ◽  
Severe Dementia ◽  
Group Activities ◽  
Video Recordings ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Total Session Time ◽  
Severity Of Dementia

ABSTRACTBackground:A variety of group activities is promoted for nursing home (NH) residents with dementia with the aim to reduce apathy and to increase engagement and social interaction. Investigating behaviors related to these outcomes could produce insights into how the activities work. The aim of this study was to systematically investigate behaviors seen in people with dementia during group activity with the seal robot Paro, differences in behaviors related to severity of dementia, and to explore changes in behaviors.Methods:Thirty participants from five NHs formed groups of five to six participants at each NH. Group sessions with Paro lasted for 30 minutes twice a week during 12 weeks of intervention. Video recordings were conducted in the second and tenth week. An ethogram, containing 18 accurately defined and described behaviors, mapped the participants’ behaviors. Duration of behaviors, such as “Observing Paro,” “Conversation with Paro on the lap,” “Smile/laughter toward other participants,” were converted to percentage of total session time and analyzed statistically.Results:“Observing Paro” was observed more often in participants with mild to moderate dementia (p = 0.019), while the variable “Observing other things” occurred more in the group of severe dementia (p = 0.042). “Smile/laughter toward other participants” showed an increase (p = 0.011), and “Conversations with Paro on the lap” showed a decrease (p = 0.014) during the intervention period.Conclusions:Participants with severe dementia seemed to have difficulty in maintaining attention toward Paro during the group session. In the group as a whole, Paro seemed to be a mediator for increased social interactions and created engagement.

How do people with dementia respond to different types of art? An explorative study into interactive museum programs

2018 ◽  
Vol 31 (06) ◽  
pp. 857-868 ◽  
Author(s):  
I. Hendriks ◽  
F. J. M. Meiland ◽  
K. Slotwinska ◽  
R. Kroeze ◽  
H. Weinstein ◽  
...  
Keyword(s):  
Cognitive Impairments ◽  
Target Group ◽  
Cross Sectional ◽  
Art Programs ◽  
People With Dementia ◽  
Study Results ◽  
Different Types ◽  
Museum Programs ◽  
Severity Of Dementia ◽  
Museum Tour

ABSTRACTObjectives:Various art programs are available for people with dementia. These have been shown to contribute to the patient’s quality of life. But are all types of art suitable for this purpose and for the target group? This study investigated whether responsiveness during museum programs depends on the type of art work shown and/or characteristics of the person with dementia, such as severity of dementia or specific cognitive impairments.Method:A cross-sectional observational study was conducted in which the responsiveness of people with dementia to different types of art was investigated as part of a study into the implementation of the Unforgettable program, an interactive guided museum tour program in Dutch museums for people with dementia.Results:The appreciative and active responsiveness and interaction with others during the program appeared related to the severity of dementia, to specific cognitive impairments, and to type of artworks. People with more severe dementia responded less to art than people with mild dementia. Artworks with more natural elements revealed less interaction with others. Artifacts (i.e., objects not originally meant as artworks) evoked more reactions than artworks.Conclusion:The study results are important to take into account when designing and offering art programs for people with dementia. Knowing which type of art works appeals most to (subgroups of) people with dementia will contribute to the optimization of art programs for this target group and to their active participation in such programs.

International Schedule for Integrated Assessment and Staging of Care for Dementia (IDEAL schedule)

2019 ◽  
pp. 13-16
Author(s):  
Maya Semrau ◽  
Alistair Burns ◽  
Antonio Lobo ◽  
Marcel Olde Rikkert ◽  
Philippe Robert ◽  
...  
Keyword(s):  
Social Support ◽  
Integrated Assessment ◽  
Psychological Symptoms ◽  
Informal Carer ◽  
Sum Score ◽  
Behavioural And Psychological Symptoms ◽  
Different Dimensions ◽  
Anchor Points ◽  
Professional Care ◽  
The Ideal

This chapter includes a complete copy of the IDEAL schedule, including its seven dimensions: 1) activities of daily living; 2) physical health; 3) cognitive functioning; 4) behavioural and psychological symptoms; 5) social support; 6) informal care, (which includes two sub-dimensions: time spent on care by informal carer and carer stress); and 7) formal professional care (which includes three sub-dimensions: total number of hours of formal professional care received, total number of hours of formal professional care needed, and additional dementia-related care needed). Each dimension has a set of anchor points, which assist the user of the schedule in rating the different dimensions appropriately. Information is also provided on how to calculate the total sum score on the IDEAL schedule.

scholarly journals Impact of COVID-19 on ‘living well’ with mild-to-moderate dementia in the community: findings from the IDEAL cohort

2021 ◽  
Author(s):  
Linda Clare ◽  
Anthony Martyr ◽  
Laura D. Gamble ◽  
Claire Louise Pentecost ◽  
Rachel Collins ◽  
...  
Keyword(s):  
Sense Of Self ◽  
Social Contact ◽  
Community Dwelling ◽  
Everyday Activities ◽  
Living Well ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Negative Impacts ◽  
The Impact ◽  
The Ideal

BackgroundNegative impacts of the COVID-19 pandemic on people with dementia have been widely-documented, but most studies have relied on carer reports and few have compared responses to information collected before the pandemic.ObjectiveWe aimed to explore the impact of the pandemic on community-dwelling individuals with mild-to-moderate dementia and compare responses with pre-pandemic data.MethodsDuring the second wave of the pandemic we conducted structured telephone interviews with 173 people with dementia and 242 carers acting as informants, all of whom had previously participated in the IDEAL cohort. Where possible we benchmarked responses against pre-pandemic data.ResultsSignificant perceived negative impacts were identified in cognitive and functional skills and ability to engage in self-care and manage everyday activities, along with increased levels of loneliness and discontinuity in sense of self and a decline in perceived capability to ‘live well’. Compared to pre-pandemic data there were lower levels of pain, depression and anxiety, higher levels of optimism, and better satisfaction with family support. There was little impact on physical health, mood, social connections and relationships, or perceptions of neighbourhood characteristics.ConclusionEfforts to mitigate negative impacts of pandemic-related restrictions and restore quality of life could focus on reablement to address the effects on participation in everyday activities, creating opportunities for social contact to reduce loneliness, and personalised planning to reconnect people with their pre-COVID selves. Such efforts may build on the resilience demonstrated by people with dementia and carers in coping with the pandemic.

scholarly journals The Use and Costs of Paid and Unpaid Care for People with Dementia: Longitudinal Findings from the IDEAL Cohort

2021 ◽  
pp. 1-18
Author(s):  
Catherine Henderson ◽  
Martin Knapp ◽  
Anthony Martyr ◽  
Laura D. Gamble ◽  
Sharon M. Nelis ◽  
...  
Keyword(s):  
Social Services ◽  
Lewy Body ◽  
Community Dwelling ◽  
Rate Of Change ◽  
Unpaid Care ◽  
Costs Of Care ◽  
People With Dementia ◽  
Diagnostic Characteristics ◽  
Growth Curve Modelling ◽  
The Ideal

Background: The drivers of costs of care for people with dementia are not well understood and little is known on the costs of care for those with rarer dementias. Objective: To characterize use and costs of paid and unpaid care over time in a cohort of people with dementia living in Britain. To explore the relationship between cohort members’ demographic and clinical characteristics and service costs. Methods: We calculated costs of health and social services, unpaid care, and out-of-pocket expenditure for people with mild-to-moderate dementia participating in three waves of the IDEAL cohort (2014– 2018). Latent growth curve modelling investigated associations between participants’ baseline sociodemographic and diagnostic characteristics and mean weekly service costs. Results: Data were available on use of paid and unpaid care by 1,537 community-dwelling participants with dementia at Wave 1, 1,199 at Wave 2, and 910 at Wave 3. In models of paid service costs, being female was associated with lower baseline costs and living alone was associated with higher baseline costs. Dementia subtype and caregiver status were associated with variations in baseline costs and the rate of change in costs, which was additionally influenced by age. Conclusion: Lewy body and Parkinson’s disease dementias were associated with higher service costs at the outset, and Lewy body and frontotemporal dementias with more steeply increasing costs overall, than Alzheimer’s disease. Planners of dementia services should consider the needs of people with these relatively rare dementia subtypes as they may require more resources than people with more prevalent subtypes.

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