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

Delirium, Dementia and Depression and Responsive Behaviours

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:

  • Screening for Delirium, Dementia and Depression in the Older Adult
  • Caregiving Strategies for Older Adults with Delirium, Dementia and Depression
  • Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour

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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Delirium Risk Factors and Interventions – RNAO Appendix G

Appendix G from pages 133-134 of Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) identifies risk factors and related interventions for delirium.

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-...

Comparison of the Clinical Features of Delirium, Dementia, and Depression – RNAO Appendix D

This helpful table from Appendix D (page 127) of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) helps to distinguish among delirium, dementia and depression where features are often similar or overlapping.

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-...

Attitudes, Skills, and Knowledge that are Beneficial for Communication in Dementia Care – RNAO Appendix K (3Ds)

This table from Appendix K pages 152-153 of the BPG Delirium, Dementia and Depression in Older Adults: Assessment and Care (2016) helps us reflect on our own attitudes, skills and knowledge about dementia and provides tips for successful interpersonal skills with residents with 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-...

Consent: Practice Guideline – College of Nurses of Ontario

This practice guideline provides an overview of the major features of the legislation, pertinent definitions, the steps nurses need to take to obtain consent and the Guidelines for Nurses Advocating for Clients Found Incapable of Making Certain Decisions. It replaces an earlier Guide to the Health Care Consent and Substitute Decisions Legislation for RNs and RPNs. It does not address consent under the Mental Health Act.

Reference: College of Nurses of Ontario Practice Guideline (2009) Consent Retrieved from: http://www.cno.org/globalassets/docs/policy/41020_consent.pdf

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Pain Assessment in Advanced Dementia (PAINAD) Scale

This resource from Interior Health, is a pain assessment tool useful for scoring pain levels of people with dementia who are unable to verbally express their pain. It focuses on assessing behaviours and provides a score rating of mild, moderate or severe pain levels.

Retrieved from: https://www.interiorhealth.ca/sites/default/files/PDFS/810310-pain-assessment-advance-dementia-scale.pdf

Warden, V., Hurley, A. & Volicer. L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. JAMDA, 4(1), 9 -15. Horgas, A., & Miller, L. (2008). Pain assessment in people with dementia. American Journal of Nursing, 108(7), 62-70.

 

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Dementia Videos - Tips from Teepa Snow

Learn more about living with dementia in these videos from Teepa Snow. She has used multi-modal therapies to support people living with dementia and their caregivers. You will find links to the following videos:

  • Dementia 101
  • Teepa's GEMS
  • Brain Changes
  • Challenging Behaviours
  • Meaingful Activities, and
  • Music

You can also visit the website http://teepasnow.com/

Refrence: Video Links for Tips from Teepa, 2016. Retrieved from http://teepasnow.com/resources/teepa-tips-videos/

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Behavioural Supports Ontario: Intervention Tool Kit - Central East LHIN

This intervention toolkit provides links to universally recognized behavioural assessment tools for common responsive behaviours. The toolkit describes possible behavioural causes and a range of strategies to help with care planning.

Reference:Central East Local Health Integration Network (LHIN) Behavioural Supports Ontario Education Committee (n.d.) Central East LHIN Behavioural Supports Ontario Intervention Tool Kit, retrieved from http://centraleast.behaviouralsupportsontario.ca/Uploads/ContentDocument...  

Acknowledgements: This tool was created by the Central East Local Health Integration Network (LHIN) Behavioural Supports Ontario Education Committee. Acknowledgment to the Psychogeriatric Resource Consults of the Central East Region for developing this tool. Thank you to the Central East Long-Term Care Homes for contributing to the development of the tool.

Disclaimer: Permission to use, copy, modify, and distribute this material for educational, research, and not-for-profit purposes, without fee and without a signed licensing agreement, is hereby granted, provided that the above copyright notice, this paragraph and the following paragraphs appear in all copies, modifications, and distributions. Contact Terry Donaghue, Technology Transfer & Industrial Liaison, Mount Sinai Hospital, & The Samuel Lunenfeld Research Institute, 600 University Avenue, Toronto, ON Canada M5G 1X5, Tel. (416) 586-8225, Fax (416) 586-3110, E-mail: donaghue@mshri.on.ca for commercial licensing opportunities.

Late Life Depression

This e-resource offered by Baycrest provides six sections of learning including understanding depression, signs and symptoms, self-check, causes, types and treatments for late-life depression.

Reference: Baycrest Health Sciences (2016) Late-Life Depression. Retrieved from http://www.baycrest.org/educate/mental-health/depression/

 

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Développement et maintien des soins de santé interprofessionnels: optimisation des résultats pour le patient, l’organisme et le système – Lignes directrices sur les pratiques exemplaires en soins infirmiers AIIAO

Les présentes lignes directrices sur les pratiques exemplaires, Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système sont conçues pour favoriser des milieux de travail sains. Les présentes lignes directrices déterminent les pratiques exemplaires pour faciliter, améliorer et maintenir le travail d’équipe ainsi que la collaboration interprofessionnelle, et pour accroître les résultats positifs pour les patients/clients, les systèmes et les organisations.

Association des infirmières et infirmiers autorisés de l’Ontario. (2013). Développement et maintien des soins de santé interprofessionnels : optimisation des résultats pour le patient/client, l’organisme et le système. Toronto, Canada: Autheur. Récupéré: http://rnao.ca/bpg/language/d%C3%A9veloppement-et-maintien-des-soins-de-sant%C3%A9-interprofessionnels-optimisation-des-r%C3%A9sul

Ce travail est financé par le Ministère de la Santé et des Soins de longue durée d'Ontario.

 

 

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