Implementing and sustaining evidence-based practices in long-term care.

Delirium, Dementia and Depression Responsive Behaviours

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    This nursing Best Practice Guideline (BPG) is intended to replace the RNAO (2010) BPGs Screening for Delirium, Dementia and Depression in Older Adults and Caregiving Strategies for Older Adults with Delirium, Dementia and Depression. It is to be used by nurses and other members of the interprofessional health-care team to enhance the quality of their practice pertaining to delirium, dementia, and depression in older adults, ultimately optimizing clinical outcomes through the use of evidence-based practices.

    Registered Nurses’ Association of Ontario. (2016). Delirium, Dementia, and Depression in Older Adults: Assessment and Care. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-older-adults-delirium-dementia-and-depression

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    The case study and its accompanying discussion guide were developed for educational purposes in long-term care homes to promote use of the RNAO Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG. This resource provides the necessary instructions to hold a facilitated discussion with long-term care staff.  Overall goals of the case study and discussion guide are to:

    • Actively engage participants in discussions about delirium, dementia, and depression
    • Help long-term care staff identify the differences between delirium, dementia, and depression
    • Help long-term care staff become familiar with key resources they can use at the point-of-care to support identification of delirium, dementia, and depression
    • Reinforce best practices for the care of delirium, dementia, depression in older adults

    Reference: Registered Nurses’ Association of Ontario. (2017). Delirium, Dementia, and Depression in Older Adults: Assessment and Care. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-older-adults-delirium-dementia-and-depression

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    The 4AT is a validated rapid assessment test for delirium and cognitive impairment. It is widely used in routine clinical practice in the UK and internationally. It is free for download and use.

    Reference: MacLullich, A., Ryan, T. and Cash, H. (2014). 4AT Rapid Assessment Test for Delirium. Retrieved from http://www.the4at.com/

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    Helping you know and exercise your rights in preparing for a time when you may be unable to make decisions about your care

    Retrieved from: http://www.seniors.gov.on.ca/en/advancedcare/docs/AdvancedCare.Guide.pdf

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    Abbey Pain Scale is an assessment tool for the measurement of pain in people with dementia who cannot verbalize

    Source: Dementia Care Australia Pty Ltd. Website: www.dementiacareaustralia.com

    Reference: Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002 (This document may be reproduced with this acknowledgment retained)Retrieved from: http://www.wales.nhs.uk/sitesplus/documents/862/FOI-286f-13.pdf

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    This template is helpful in identifying and altering the antecedent and consequences to change behaviour.

    Registered Nurses' Association of Ontario. (2012). Appendix L of Promoting Safety: Alternative Approaches to the Use of Restraints. Toronto, ON, Canada: Author. p. 113 Retrieved from http://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints

    Adapted from Proulx. 10

    Source: Omelan, C. (2006). CME: Approach to Managing Behavioural Disturbances in Dementia. Canadian Family Physician, February, 52, p. 193

    Reprinted with permission from the Canadian Family Physician

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    This OAHNSS package of January 27, 2011 contains a sample policy, procedures and staff training materials and tools that meet the minimum requirements of the LTCHA and regulation. Scroll down to the Responsive Behaviours section of the OAHNSS website.

    The Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS) Long-Term Care Homes Act (LTCHA) Implementation Member Support Project resources are confidential documents for OANHSS members only. Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information, by persons or entities other than the intended recipients is prohibited without the approval of OANHSS. The opinions expressed by the contributors to this work are their own and do not necessarily reflect the opinions or policies of OANHSS. LTCHA Implementation Member Support Project resources are distributed for information purposes only. The Ontario Association of Non-Profit Homes and Services for Seniors is not engaged in rendering legal or other professional advice. If legal advice or other expert assistance is required, the services of a professional should be sought.

    Retrieved from: http://www.oanhss.org/oanhssdocs/Media_Centre/LTCHomesActCentralseeSiteNavigation/Responsive_Behaviours_PandP_Training_Package.pdf

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    The ACE Website provides materials for public education on prevention of elder abuse. Materials include information on powers of attorney, consumer protection and legal issues affecting older persons.

    Advocacy Centre for the Elderly (ACE) (2013) Retrieved from http://acelaw.ca

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    This heart-warming video shows how music can transform the life of a resident with dementia.

    Reference: Sundance Film Festival. (2014, January 7) Alive Inside: A Story of Music & Memory Featurette - Documentary HD. Retrieved from https://youtu.be/8HLEr-zP3fc

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    The link takes you to the altercations and other interactions section 54 of the Ontario Regulation 79/10 made under the Long-Term Care Homes Act, 2007, Government of Ontario. Retrieved from https://www.ontario.ca/laws/regulation/r10079