Nurse aides' identification of onset and level of agitation in late stage dementia patients

Two reliability studies were performed on a recently developed cognitive assessment battery for severe dementia. The method, the Modified Ordinal Scales of Psychological Development (M-OSPD), is based on the Piagetian developmental model of sensorimotor functions. Procedures have been adapted from this test battery, which was originally applied to infants and small children, for the assessment of remaining cognitive capacity in severe dementia. Two independent interrater reliability studies were conducted. In these studies, two different raters simulataneously evaluated patients with severe dementia. One interrater reliability study was performed in a nursing home setting (Study 1), and the other reliability study consisted of a sample of community-residing patients (Study 2). The Global Deterioration Scale and the Mini-Mental State Examination were used to assess dementia severity. Study 1 (N = 22) resulted in an intraclass correlation coefficient (ICC) of .99 (p < .01) for the M-OSPD total score. Study 2(N = 19) resulted in an ICC of .96 (p < .01) for the M-OSPD total score. The M-OSPD proved to be a reliable instrument in these studies. This cognitive assessment measure can provide meaningful information regarding the cognitive abilities of late-stage dementia patients. Until recently, these late-stage dementia patients had been considered untestable in studies that utilized conventional psychometric and mental status evaluation measures.

Download Full-text

Seeking Meaning in Late Stage Dementia

Journal of Pastoral Care & Counseling Advancing theory and professional practice through scholarly and reflective publications ◽

10.1177/154230500505900403 ◽

2005 ◽

Vol 59 (4) ◽

pp. 335-343 ◽

Cited By ~ 1

Author(s):

Charles E. Woodman

Keyword(s):

Literature Review ◽

Case Studies ◽

Late Stage ◽

Family Members ◽

Family Carers ◽

Loved One ◽

Care Theory ◽

James Hillman ◽

Dementia Patients

The author uses case studies to illustrate the effectiveness of two techniques which pastoral caregivers may teach to family carers of dementia patients. In the last stages of dementia, it is important to seek meaning and keep in significant contact as long as possible, both for family members as well as for the dementia patients. After a brief literature review, implications for care theory, practice, and policy are reviewed, and a scientific bias is illustrated. These techniques build on the work of C. G. Jung and James Hillman, utilizing metaphor in non-rational uses of language. It is suggested that pastoral caregivers could teach these techniques to families of this population, in the hope of prolonging meaningful connection with their loved one.

Download Full-text

Emotional Expression During Mid- to Late-Stage Dementia

International Psychogeriatrics ◽

10.1017/s104161029600275x ◽

1996 ◽

Vol 8 (3) ◽

pp. 383-395 ◽

Cited By ~ 72

Author(s):

Carol Magai ◽

Carl Cohen ◽

David Gomberg ◽

Chris Malatesta ◽

Clayton Culver

Keyword(s):

Late Stage ◽

Coding System ◽

Global Deterioration Scale ◽

Dementia Patients ◽

Nursing Home Patients ◽

Degenerative Dementia ◽

Primary Degenerative Dementia ◽

End Stage ◽

Emotional Responsivity

This study examined the quality of emotional responsivity in mid-to late-stage dementia patients. Eighty-two nursing home patients with a DSM-III-R diagnosis of primary degenerative dementia of the Alzheimer type served as subjects. Patients were staged using the Global Deterioration Scale. The level and type of patient affectivity were assessed by family reports, aide reports, and direct observation and coding of patient facial expressions during a family visit. All three measures indicated that patients with Alzheimer's disease expressed a range of affective signals. Some showed an intact and functional emotion system even during the last stage of the disease; one third of end-stage dementia patients expressed sadness at the departure of their relatives as coded by an objective facial affect coding system.

Download Full-text

A Novel Screening Method to Identify Late-Stage Dementia Patients for Palliative Care Research and Practice

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2017.12.480 ◽

2018 ◽

Vol 55 (4) ◽

pp. 1152-1158.e1 ◽

Cited By ~ 8

Author(s):

Natalie C. Ernecoff ◽

Kathryn L. Wessell ◽

Stacey Gabriel ◽

Timothy S. Carey ◽

Laura C. Hanson

Keyword(s):

Palliative Care ◽

Late Stage ◽

Screening Method ◽

Research And Practice ◽

Care Research ◽

Dementia Patients

Download Full-text

Existential Concerns of Families of Late-Stage Dementia Patients: Questions of Freedom, Choices, Isolation, Death, and Meaning

Journal of Palliative Medicine ◽

10.1089/109662103764978470 ◽

2003 ◽

Vol 6 (2) ◽

pp. 225-235 ◽

Cited By ~ 38

Author(s):

Lars Albinsson ◽

Peter Strang

Keyword(s):

Late Stage ◽

Dementia Patients ◽

Existential Concerns

Download Full-text

Group Management of Dementia Patients in a Day-Care Center

International Psychogeriatrics ◽

10.1017/s1041610200007298 ◽

2000 ◽

Vol 12 (S1) ◽

pp. 367-372 ◽

Cited By ~ 1

Author(s):

Ruben Muñiz ◽

Nina Morillas ◽

Javier Olazarán ◽

María José González ◽

Marta Neira ◽

...

Keyword(s):

Group Theory ◽

Day Care ◽

Middle Management ◽

Care Center ◽

Day Care Center ◽

Group Management ◽

Dementia Patients ◽

Management Techniques ◽

The Moment ◽

Nurse Aides

Our top and middle management initially received thorough training in group theory and group management techniques for organizational reasons. In daily shift meetings, nurse aides (NAs) learn some of the techniques and approaches, translating part of them to work with patients. From the moment we started to focus on the day-care center patients as a group to be managed every minute, we found that disturbances decreased significantly (based on empiric assessment by staff).

Download Full-text