Prevalence of dementia and organization of dementia care in Swiss disability care homes

Wicki, Monika T.; Riese, Florian

doi:10.1016/j.dhjo.2016.05.008

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…One alternative would have been to classify individuals based on dementia status (e.g., no dementia diagnosis throughout the observation period, incident dementia, and dementia diagnosis from the beginning). Although our study includes relatively frequent measures of the CPS score, dementia status is typically not as frequently assessed in nursing homes, leading to a considerable diagnostic gap [41][42][43]. Thus, even if a person is not diagnosed with dementia until their death, we will not know with certainty that they were indeed free of dementia symptoms.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Change at the End of Life in Nursing Home Residents: Differential Trajectories of Terminal Decline

et al. 2018

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Background: Research on terminal decline has widely documented that cognitive performance steeply declines with nearing death. To date, it is unclear whether these changes are normative, based on pathologies associated with (preclinical) dementia, or both. Objectives: We analyzed heterogeneity in trajectories of terminal cognitive change in Swiss nursing home residents with the objective of examining whether terminal change is normative or whether one or multiple subgroup(s) with relative stability exist. Methods: We performed a longitudinal analysis based on routine assessments with the Resident Assessment Instrument – Minimal Data Set in 341 nursing homes between 1998 and 2014. In sum, we used 143,052 observations from 30,054 residents (69% women, average age at death 87 years) in the last 3 years of life. We analyzed trajectories of the Cognitive Performance Scale (CPS) score with latent class growth curve models and examined sociodemographic factors (age at death, sex, marital status, prior living situation) as well as functional and mental health (Activities of Daily Living Index and Depression Rating Scale) and dementia diagnosis as correlates of group membership. Results: We identified three distinct classes based on longitudinal trajectories of the CPS score. In the first group (transition from no to mild impairment, 27%), cognitive impairment increased with time to death (linear and quadratic), but remained at relatively mild levels at all times. The trajectories of the second group (transition from moderate to severe impairment, 43%) were characterized by linear and quadratic changes across time to death. The trajectories of the third group (severe impairment, 30%) were characterized by the lowest amount of linear increase across all groups and no quadratic increase indicating no accelerated change. Better functional health and absence of a dementia diagnosis predicted less impairment. Fewer depressive symptoms were associated with low as opposed to moderate or severe, but also severe versus moderate impairment. Conclusion: Our findings suggest that the majority of residents experience terminal change, with the exception of those at already high levels of impairment. Furthermore, late-life cognitive change is related to functional and mental health.

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Section: Discussionmentioning

confidence: 99%

Cognitive Change at the End of Life in Nursing Home Residents: Differential Trajectories of Terminal Decline

et al. 2018

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“…The rater population—frontline staff working with people with dementia—is primarily made up of nurses with secondary vocational training degrees or without formal training but with several years of employment and clinical exposure [ 18 , 25 ]. In Swiss nursing homes, less than one-fifth of the staff working with people with dementia are registered nurses; therefore, we included interns, healthcare assistants and nurses with secondary vocational training.…”

Section: Introductionmentioning

confidence: 99%

Inter-rating reliability of the Swiss easy-read integrated palliative care outcome scale for people with dementia

et al. 2023

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Background The Integrated Palliative Care Outcome Scale for People with Dementia is a promising instrument for nursing home quality improvement and research in dementia care. It enables frontline staff in nursing homes to understand and rate the needs and concerns of people with dementia. We recently adapted the measure to include easy language for users from various educational backgrounds. Objectives In this study, we examine the inter-rating reliability of the Integrated Palliative Care Outcome Scale for People with Dementia for frontline staff in nursing homes. Methods In this secondary analysis of an experimental study, 317 frontline staff members in 23 Swiss nursing homes assessed 240 people with dementia from a convenience sample. Reliability for individual items was computed using Fleiss Kappa. Because of the nested nature of the primary data, a generalisability and dependability study was performed for an experimental IPOS-Dem sum score. Results The individual Integrated Palliative Care Outcome Scale for People with Dementia items showed kappa values between .38 (95% CI .3–.48) and .15 (95% CI .08–.22). For the experimental IPOS-Dem sum score, a dependability index of .57 was found. The different ratings and time between ratings explain less than 2% of the variance in the sum score. The different nursing homes make up 12% and the people with dementia make up 43% of the sum score variance. The dependability study indicates that an experimental IPOS-Dem sum score could be acceptable for research by averaging two ratings. Conclusion Limited research has been conducted on the measurement error and reliability of patient-centred outcome measures for people with dementia who are living in nursing homes. The Swiss Easy-Read IPOS-Dem is a promising instrument but requires further improvement to be reliable for research or decision making. Future studies may look at its measurement properties for different rater populations or at different stages of dementia. Furthermore, there is a need to establish the construct validity and internal consistency of the easy-read IPOS-Dem.

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Neurocognitive Disorders Assessments

Gomiero

Ali

Santos

2020

Mental Health, Intellectual and Developmental Disabilities and the Ageing Process

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Prevalence of dementia and organization of dementia care in Swiss disability care homes

Cited by 4 publications

References 18 publications

Cognitive Change at the End of Life in Nursing Home Residents: Differential Trajectories of Terminal Decline

Cognitive Change at the End of Life in Nursing Home Residents: Differential Trajectories of Terminal Decline

Inter-rating reliability of the Swiss easy-read integrated palliative care outcome scale for people with dementia

Neurocognitive Disorders Assessments

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