The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of ResponsiveBehaviours and Delirium, Dementia and Depression Best Practice Guidelines:
Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Program team. Visit this site often to see what's new!
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Confusion Assessment Method (CAM) helps identify individuals who may be suffering from delirium or an acute confusional state and is useful for distinguishing between delirium and dementia. There are choices such as the long or short version CAM or the 3D CAM.
Reference: Hospital Elder Life Program (2003). Confusion Assessment Method. Retrieved from http://www.hospitalelderlifeprogram.org/delirium-instruments/
The Centre for Effective Practice provides the BPSD Discussion Guide designed to help providers understand, assess, and manage residents in long-term-care homes with behavioural and psychological symptoms of dementia, with a focus on antipsychotic medications.
Reference: Centre for Effective Practice (2016). Use of Antipsychotics in Behavioural and Psychological Symptoms of Dementia (BPSD) Discussion Guide. Retrieved from https://cep.health/media/uploaded/UseofAntipsychotics_LTC2016-2.pdf
© April 2016. Version 2. Centre for Effective Practice Inc. All Rights Reserved.
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/
Appendix E pages 128-130 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) identifies the major types of dementia and a description of each.
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-...
This table from pages 83-84 of the Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG (2016) informs nurse educators of relevant content for designing education sessions for those caring for clients with delirium, dementia and depression.
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-...
This table from page 71 of the Delirium, Dementia, and Depression in Older Adults: Assessment and Care BPG (2016) looks at predisposing and precipitating risk factors as well as signs of depression.
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-...
This Table from page 61 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) describes non- pharmacological approaches to use to minimize behavioural and psychological symptoms of dementia.
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-...
This table from page 76-77 of the Delirium, Dementia, Depression in Older Adults: Assessment and Care BPG (2016) reviews interventions for depression, including psychotherapy, psychological/social and antidepressants.
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-...
This flow chart from page 33 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) provides a concise and systematic overview of the best practice recommendations.
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-...
This resource from pages 94-98 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) includes structure, process and outcome indicators helpful in evaluating the changes made by an organization.
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-...
