Observational assessment of communication to empower patients with dementia to make legally effective decisions – revalidation of CODEM<sub>amb</sub>

Haberstroh, Julia; Penger, Susanne; Messemaker, Anne; Knebel, Maren

doi:10.1080/13607863.2021.1952549

Cited by 3 publications

(4 citation statements)

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“…However, dual tasking is usually difficult for PwD (Haberstroh, Neumeyer, et al, 2011). So these items could be more difficult than the verbal items, which are rated only by observation (Haberstroh et al, 2022). Future studies should address this issue as well, e.g., by investigating the role of item difficulty in nonverbal communication behavior.…”

Section: Discussionmentioning

confidence: 99%

“…13 and 14) from the verbal subscale and 1 item (No. 19) from the nonverbal subscale (for further information, see Haberstroh et al, 2022).…”

Section: Methodsmentioning

confidence: 99%

“…The current study is based on data from the research project EmMa (Förderung der E inwilligungsfähigkeit in m edizinische Ma ßnahmen bei Demenz durch ressourcenorientierte Kommmunikation [Promotion of Capacity to Consent to Medical Treatment Among Persons with Dementia by Means of Resource-Oriented Communication]. For more information on the project, see Haberstroh et al (2022) and Poth et al (2023).…”

Section: Methodsmentioning

confidence: 99%

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The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

et al. 2023

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Any medical treatment that interferes with physical integrity requires the informed consent of a patient capable of such consent. For people with dementia, the capacity to consent is questioned even in the early course of the disease. Particularly diagnostic instruments like the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) often deny people with dementia the capacity to consent because of high confounding of the results with patients’ verbal abilities. To date, it remains unclear whether not only verbal but also nonverbal communication is associated with assessments of capacity to consent. The current study investigates associations between patients’ verbal and nonverbal communication behaviors as assessed by the measure for Communication Behavior in People with Dementia in Ambulant Settings (CODEMamb) and capacity to consent as assessed by the MacCAT-T. We expected the strongest positive associations for verbal communication behaviors compared to nonverbal communication behaviors. Data of N = 43 patients with dementia ( n = 8 capable of consent) were collected at two different German psychiatric clinics. The results show small to moderate correlations between the overall scores of CODEMamb and MacCAT-T. As expected, correlations were strongest for the verbal CODEMamb subscale. The results support current findings on the dependency of the MacCAT-T on verbal communication. Based on the findings, the discussion addresses how people with dementia can be enabled to make self-determined medical treatment decisions.

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Section: Discussionmentioning

confidence: 99%

“…13 and 14) from the verbal subscale and 1 item (No. 19) from the nonverbal subscale (for further information, see Haberstroh et al, 2022).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

et al. 2023

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“…Besides verbal and non-verbal content aspects, the non-verbal relationship aspect is an important component of communication [ 8 , 10 ]. Examples of these are feelings, mental states, and expressions of emotion [ 11 ]. Knebel et al [ 10 ] showed that people with mild and moderate dementia also performed better in relationship aspects of communication than in content-related aspects.…”

Section: Introductionmentioning

confidence: 99%

Project DECIDE, part II: decision-making places for people with dementia in Alzheimer’s disease: supporting advance decision-making by improving person-environment fit

Florack¹,

Abele²,

Baisch³

et al. 2023

BMC Med Ethics

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Background The UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer’s disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the ‘spatial intervention study’ of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. Methods People with a suspected or confirmed diagnosis of dementia in Alzheimer’s disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed. Discussion The results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice. Trial registration: DRKS00030799.

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Empowering patients with dementia to make legally effective decisions: a randomized controlled trial on enhancing capacity to consent to treatment

Poth

Penger

Knebel

et al. 2022

Aging & Mental Health

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Observational assessment of communication to empower patients with dementia to make legally effective decisions – revalidation of CODEM_amb

Cited by 3 publications

References 15 publications

The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

Project DECIDE, part II: decision-making places for people with dementia in Alzheimer’s disease: supporting advance decision-making by improving person-environment fit

Empowering patients with dementia to make legally effective decisions: a randomized controlled trial on enhancing capacity to consent to treatment

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Observational assessment of communication to empower patients with dementia to make legally effective decisions – revalidation of CODEMamb

Cited by 3 publications

References 15 publications

The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

The Role of Different Aspects of Communication Behavior in the Assessment of Capacity to Consent

Project DECIDE, part II: decision-making places for people with dementia in Alzheimer’s disease: supporting advance decision-making by improving person-environment fit

Empowering patients with dementia to make legally effective decisions: a randomized controlled trial on enhancing capacity to consent to treatment

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Observational assessment of communication to empower patients with dementia to make legally effective decisions – revalidation of CODEM_amb