This book can serve as an aid for individuals, organizations, and agencies who are considering developing a day care program for patients with Alzheimer's disease, or a related dementia. It is also intended for those who are already operating an adult day care program they wish to modify to include persons with dementia.
in the frequency of disruptive behaviours including verbally and physically abusive behaviour; socially inappropriate behaviours; and resistance to care (Table 2). In addition, their RAI-MDS Aggressive Behaviour Scale score remained unchanged and fewer residents were falling as their antipsychotic medications were reduced or discontinued. Conclusions: These early results demonstrate that data-driven, person-centered dementia care approaches have potential to reduce inappropriate use of antipsychotics in LTC and improve the quality of residents' care experience, clinical outcomes including reduction in falls ( Figure 1) and disruptive behaviours ( Figure 2). The presentation will highlight qualitative and quantitative outcomes from the collaborative, a team case study, and a facility-level and target cohort analysis that illustrates the impact of participating and non-participating LTC facilities across Canada using a longitudinal comparison of risk-adjusted interRAI 2.0 quality indicators. 1 Vigen CLP et al. Cognitive effects of atypical antipsychotic medications in patients with Alzheimer's disease: outcomes from CATIE-AD. Am J Psychiatry 2011; 168:831-839.Table 2 RAI-MDS 2.0 Outcome Measures in residents discontinued or reduced from antipsychotic medication at Baseline and Q3 (n¼222) Baseline Q3 % change n % n % RAI-MDS 2.0 Outcome Scales Moderate cognitive impairment or greater (CPS Score 3-6, %) 194 87% 197 89% 1.5% Higher impairment in ADL performance (ADL Long Form Score 14-23, %) 134 60% 158 71% 17.9% Potential or actual problem with depression (DRS score 3-14, %) 70 32% 71 32% 1.4% Very severe aggressive behaviour (ABS Score 8-12, %) 29 13% 28 13% -3.4% Daily pain/severe daily pain (Pain Scale Score of 2-3, %) 42 19% 40 18% -4.8% Higher social engagement (ISE Score 4-6, %) 57 26% 62 28% 8.8% Table 3 Behaviour Symptoms and Falls in residents discontinued or reduced from antipsychotic medication at Baseline and Q3 (n¼222) Baseline Q3 % change n % n % Frequency of Behaviour Symptoms Exhibiting verbally abusive behaviour daily or less than daily, % 30 14% 20 9% -33.3% Exhibiting physically abusive behaviour daily or less than daily, % 18 8% 13 6% -27.8% Exhibiting socially inappropriate/disruptive behaviours daily or less than daily, % 31 14% 23 10% -25.8% Resisting care daily or less than daily, % 58 26% 45 20% -22.4% Falls Fell in the last 30 days (yes, %) 41 18% 33 15% -20% Baseline Q1 Q2 Q3 n % n % n % n % Very severe aggressive behaviour (ABS Score 6-12, %) 84 15% 70 14% 60 13% 64 15% Daily pain/severe daily pain (Pain Scale Score of 2-3, %) 107 19% 84 17% 74 16% 68 16% Higher social engagement (ISE Score 4-6, %) 167 29% 156 31% 146 32% 136 33% Frequency of Behaviour Symptoms Exhibiting verbally abusive behaviour daily or less than daily, % 76 13% 69 14% 62 14% 49 12% Exhibiting physically abusive behaviour daily or less than daily, % 54 9% 44 9% 44 10% 39 9% Exhibiting socially inappropriate/disruptive behaviours daily or less than daily, % 33 16% 77 15% 66 15% 65 16% Resisting care daily or less than d...
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