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

Delirium, Dementia and Depression Responsive Behaviours

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  • RNAO BPG - Delirium, Dementia, and Depression in Older Adults: Assessment and Care
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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

  • RNAO BPG Gap Analysis- Delirium, Dementia and Depression in Older Adults
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    A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.

    Registered Nurses Association of Ontario (2022) Gap Analysis-Delirium, Dementia and Depression in Older Adults . Toronto, ON.

     

  • 3Ds Long-Term Care Case Study and Discussion Guide - RNAO
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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

  • 4AT Rapid Assessment Test for Delirium
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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/

  • Abbey Pain Scale
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    The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in patients who are unable to clearly articulate their needs, for example, patients with dementia, cognition or communication issues. The scale does not differentiate between distress and pain, so measuring the effectiveness of pain-relieving interventions is essential.

    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.

    https://www.apsoc.org.au/PDF/Publications/Abbey_Pain_Scale.pdf

     

     

     

     

     

     

     

     

     

  • ABC (Antecedent, Behaviour, Consequences) Charting Template - RNAO Appendix L
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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, Canada: Author.  (p. 113). Retrieved from https://rnao.ca/sites/rnao-ca/files/Promoting_Safety_-_Alternative_Approaches_to_the_Use_of_Restraints_0.pdf

    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

  • Advocacy Centre for the Elderly (ACE) - Website
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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

  • Alive Inside: A Story of Music & Memory Featurette - Documentary
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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

  • Alzheimer Canada: Resources for Health Care Professionals
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    This Alzheimer Canada website section provides resources for health care professionals.  Ambiguous Grief and Loss, Pain, End of Life and Culture Change, is a resource that addresses the issue of loss and grief while supporting those living with dementia and their caregivers.

    Retrieved from: https://alzheimer.ca/en/help-support/i-have-friend-or-family-member-who-lives-dementia/managing-ambiguous-loss-grief

    ©2024 Alzheimer Society of Canada. All rights reserved.

  • Alzheimer Society of Ontario - Website
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    This organization provides support to families and clients affected by Alzheimer’s disease. Links are provided to a chapter near you. Web site is also available in French.  Website: www.alzheimer.ca/en/on.

    The Website is copyrighted by the Alzheimer Society of Canada.

  • Attitudes, Skills, and Knowledge that are Beneficial for Communication in Dementia Care – RNAO
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    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-dementia-and-depression

  • Behavioural Supports Ontario - (DOS) Dementia Observation System©
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    The BSO-DOS© is an observational tool that helps to identify patterns of behaviour for care planning purposes. It is based on the former DOS. Simple registration is required to access this free tool. A user guide and resource manual are available.

    Behavioural Supports Ontario. (2019). Behavioural Supports Ontario - Dementia Observation System. Retrieved from https://brainxchange.ca/BSODOS

     

  • Behavioural Supports Ontario person-centred language initiative report
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    This report provides rationale for using person-centred care language and helpful strategies for changing practice.

    Behavioural Supports Ontario. (October, 2018). Behavioural Supports Ontario person-centred language initiative report. Retrieved from http://www.behaviouralsupportsontario.ca/Content/Pledge/BSO_Person-Centred_Language_Initiative_Report%20_October_2018.pdf

     

  • Behavioural Supports Ontario: Intervention Tool Kit - Central East LHIN
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    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/ContentDocuments/Intervention%20Tool%20Kit_Version%201_May_2016.pdf  

    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.

  • Behavioural Symptoms of Dementia – HQO Quality Standards
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    This HQO quality standard addresses care for people living with dementia and the specific behaviours of agitation and aggression. Accompanying resources include a Patient and Resident Reference Guide and Recommendations for adoption.

    Reference: Health Quality Ontario (2016). Behavioural Symptoms of Dementia. Care for Patients in Hospitals and Residents in Long-Term Care Homes. Retrieved from http://www.hqontario.ca/Evidence-to-Improve-Care/Quality-Standards/View-all-Quality-Standards/Behavioural-Symptoms-of-Dementia/ 

  • Brain X Change
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    The brainXchange™ provides resources to support improving the quality of life for persons with, or at risk of having brain-health needs related to dementia, mental health and neurological conditions related to brain health changes or aging.

    Retrieved from: https://brainxchange.ca/

    © 2024 brainXchange™ 

  • Comparison of the Clinical Features of Delirium, Dementia, and Depression – RNAO Appendix D
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    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-dementia-and-depression

  • Consent: Practice Guideline – College of Nurses of Ontario
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    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

  • Conversations about dementia, intimacy and sexuality
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    This conversation sheet from Alzheimer Canada informs how dementia can affect intimacy and sexuality. Strategies are provided for caregivers. There is also a section to support LGBTQ persons with dementia.

    The Alzheimer Society is Canada’s leading health charity for people living with Alzheimer’s disease and other dementias. For more information visit the home page www.alzheimer.ca  

    Alzheimer Canada (2018). Conversations about dementia, intimacy and sexuality. Retrieved from https://alzheimer.ca/sites/default/files/files/national/brochures-conversations/conversations_intimacy-and-sexuality.pdf

     

  • Delirium Risk Factors and Interventions – RNAO Appendix G
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    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-dementia-and-depression

  • Dementia Factsheets - Indigenous Cognitive and Aging Awareness Research Exchange (I-CAARE)
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    Indigenous Cognitive and Aging Awareness Research Exchange (I-CAARE) offers a number of factsheets, a health wheel and pathway for persons with dementia and their caregivers. The indigenous perspective may provide added support and comfort to families as they journey through dementia.

    Reference: Indigenous Cognitive and Aging Awareness Research Exchange (2023). Dementia Factsheets. Retrieved from: https://www.i-caare.ca/dementia-s 

    ©  2023 ICARE  Owned by Dr. Kristen Jacklin

  • Dementia Videos - Tips from Teepa Snow
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    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/

  • Développement et maintien des soins de santé interprofessionnels: optimisation des résultats
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    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.

     

     

  • DOLOPLUS-2 Scale – Behavioural Pain Assessment in the Elderly
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    Behavioral pain assessment scale for the elderly presenting with verbal communication disorders, DOLOPLUS consists in an observation form consisting of 10 items divided into 3 sub-groups proportionally to the observed frequency (5 somatic items, 2 psychomotor items and 3 psychosocial items).

    Retrieved from: https://www.doloplus.fr/pdf/doloplus-en.pdf

    Copyright

     

  • Evaluating and Monitoring – Structure, Process, and Outcome Indicators – RNAO Table 10
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    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-dementia-and-depression

  • Finding Your Way - Alzheimer Society Ontario
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    Alzheimer Society Ontario's Finding Your Way® helps people living with dementia, their families, caregivers and communities to recognize the risk of going missing, be prepared for incidents of going missing, and ensure that people with dementia can live safely in the community. At this link you will find free On-line Learning about keeping people with dementia safe. You will also find a Living Safely with Dementia Resource Guide and an interactive resource guide. http://findingyourwayontario.ca/ 

    Alzheimer Society of Canada (2018). Finding Your Way. http://findingyourwayontario.ca/ 

    2018 Alzheimer Society of Canada

  • Flow Chart for Delirium, Dementia, and Depression – RNAO
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    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-dementia-and-depression

  • Gentle Persuasive Approach (GPA) in Dementia Care - Website
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    This web link provides GPA training information and educational resources. access to GPA newsletters. The Advanced Gerontological Education Website is www.ageinc.ca.

     

  • Geriatric Depression Scale (GDS) Long Form
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    The Geriatric Depression Scale, is a screening tool used to assessment depression in older adults. It is available in both long form and short form versions and also in multiple languages. The link below is for the long form.

    Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17:37-49

    Retrieved from: https://integrationacademy.ahrq.gov/sites/default/files/2020-07/Update%20Geriatric%20Depression%20Scale-30.pdf

  • Geriatric Depression Scale (GDS) Short Form
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    The Geriatric Depression Scale, is a screening tool used to assessment depression in older adults. It is available in both long form and short form versions and also in multiple languages. The link below is for the short form.

    Reference: Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.

    Retrieved from: https://integrationacademy.ahrq.gov/sites/default/files/2020-07/Update_Geriatric_Depression_Scale-15.pdf

    (Sheikh & Yesavage, 1986)

  • Interventions for Depression – RNAO Table 5
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    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-dementia-and-depression

  • Late Life Depression
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    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/

     

    © 2016 BAYCREST HEALTH SCIENCES - ALL RIGHTS RESERVED. UNAUTHORIZED COPYING, REPRODUCTION, REPUBLISHING, UPLOADING, DOWNLOADING, POSTING, TRANSMITTING OR DUPLICATING ANY OF THE MATERIAL FOUND ON THIS WEBSITE IS PROHIBITED. Your use of this site constitutes your agreement to abide by these Terms of Use. Baycrest reserves the right, in their sole discretion, to modify, alter or otherwise update these Terms of Use at any time and you agree to be bound by such modifications, alterations or updates. You agree to review these Terms of Use on an ongoing basis. Baycrest hereby grants you a personal, non-exclusive, non-assignable and non-transferable license to use and display, one copy of any Material and/or software that you may download from this site, including, but not limited to, any files, codes, audio or images incorporated in or generated by the software (collectively called the “Downloaded Material”) provided, however, that you must maintain all copyright and other notices contained in such Downloaded Material. You acknowledge and agree that you may not sublicense, assign or otherwise transfer this license or the Downloaded Material and that no title to the Downloaded Material has been or will be transferred to you from Baycrest or anyone else. You also agree that you will not alter, disassemble, decompile, reverse engineer or otherwise modify the Downloaded Material.

  • Mental health and older adults (WHO)
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    This WHO webpage, Mental Health of Older Adults, recognizes dementia and depression in older adults as a global public health issue and identifies interventions.

    World Health Organization. (12 December, 2017). Mental Health of Older Adults. Retrieved from www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults

    Licence: CC BY-NC-SA 3.0 IGO.

     

  • Mini-Cog™ - Instructions for Administration and Scoring
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    The Mini-Cog is a brief screening instrument to determine memory recall and clock drawing ability. A positive screen would suggest more in-depth assessment for cognitive impairment. Mini-Cog instrument, instructions and scoring are provided.

    Reference: Borson, S. (n.d.). Mini-Co. Retrieved from https://mini-cog.com/

    Mini-Cog™ © S. Borson. All rights reserved. Reprinted with permission of the author solely for clinical and educational purposes. May not be modified or used for commercial, marketing, or research purposes without permission of the author (soob@uw.edu). v. 01.19.16

  • Montreal Cognitive Assessment (MoCA)©
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    A useful tool for assessing early stage dementia.  For more information or feedback on MoCA© contact Dr Z. Nasreddine at info@mocatest.org.

    Nasreddine, Z.  (2003). Welcome to the Montreal Cognitive Assessment.   Quebec, QC, Canada: Center for Diagnosis & Research on Alzheimer’s disease.  Retrieved from www.mocatest.org.  Copyright Dr Z. Nasreddine 2003 to 2013 - The Montreal Cognitive Assessment - MoCA© - All rights reserved.

  • Music and Memory™
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    Music and Memory looks at how music can enrich the lives of long-term care residents with cognitive impairment.

    Reference: Blanchard, Laurie (2016). Music and Memory. Retrieved from http://libguides.lib.umanitoba.ca/ld.php?content_id=25047510

  • National Initiative for the Care of the Elderly (NICE) - Website
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    National Initiative for the Care of the Elderly (NICE) is an international network of researchers, practitioners, and students dedicated to improving the care of older adults in Canada and abroad. The website includes various resources, some specific to dementia care and caregiving.

    Reference:National Initiative for the Care of the Elderly (NICE) Website: http://www.nicenet.ca/

  • Non-pharmacological Approaches to Management of the Behavioural and Psychological Symptoms of
    Show description [+]

    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-dementia-and-depression

  • Office of the Public Guardian and Trustee (OPGT) - Website
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    The Office of the Public Guardian and Trustee (“OPGT”) delivers a unique and diverse range of services that safeguard the legal, personal and financial interests of certain private individuals and estates. Services are provided by multi-disciplinary teams of dedicated staff with experience in the health care, social work and financial planning fields. They receive professional support from lawyers, accountants and investigators. A brief description of many of the services offered by the OPGT is set out in the website.

    Reference: Office of the Public Guardian and Trustee (OPGT)

    Website: https://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/overview.php

  • Ontario Regulation 246/22
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    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • P.I.E.C.E.S.™ Canada -Website
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    This website provides information and resources about the P.I.E.C.E.S.™ program. "Putting the P.I.E.C.E.S.™ Together" represents Physical, Intellectual, Emotional, Capabilities, Environment, Social, and are the cornerstones of the philosophy and care of the P.I.E.C.E.S.™ approach.

    P.I.E.C.E.S.™ (n.d.). P.I.E.C.E.S. website. Retrieved from http://pieceslearning.com/

     

  • Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC)
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    PACSLAC is a tool to observe and assess both common and subtle pain behaviours. Copyright © Shannon Fuchs-Lacelle and Thomas Hadjistavropoulos. The PACSLAC may not be reproduced without permission. For permission to reproduce the PACSLAC, please contact the copyright holders (Thomas.Hadjistavropoulos@uregina.ca).

    Retrieved from: https://gerocentral.org/wp-content/uploads/2013/12/Pain-Assessment-Checklist-for-Seniors-with-Limited-Ability-to-Communicate-PASLAC.pdf

  • Pain Assessment in Advanced Dementia (PAINAD) Scale
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    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.

     

  • Parkinson Canada - Website
    Show description [+]

    The Parkinson Canada website contains several useful resources for LTC including a Guide to the Non-Motor Symptoms of Parkinson's Disease (client and physician versions). These guides cover cognitive dysfunction, dementia, anxiety, depression, delusions and impulse control in Parkinson's disease. Also available is a booklet specific to the LTC sector as well as a medication booklet.

    Reference: Parkinson Canada website, retrieved from http://www.parkinson.ca/

  • Partnerships in Dementia Care (PiDC) Alliance - Website
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    Partnerships in Dementia Care Alliance (PiDC) helps to change culture in long-term care and community settings to enhance dementia care. Examples of culture change in LTC homes is included.

    Reference: Partnerships in Dementia Care Alliance Website: https://uwaterloo.ca/partnerships-in-dementia-care/

  • RAI-MDS© and P.I.E.C.E.S.™ Integration Job Aid
    Show description [+]

    The provincial RAI-MDS© and P.I.E.C.E.S.™ Integration Working Group have developed a Job Aid that allows for the streamlining of the RAI assessment and the P.I.E.C.E.S. 3-Question Assessment and Care Planning Framework.

    Retrieved from: http://piecescanada.com/index.php?option=com_content&view=article&id=27&Itemid=30

  • Resources for Healthcare Providers
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    Delirium resources for healthcare providers. Includes posters, communication tips, clinician learning series slide deck, delirium prevention toolkit, how to prevent and support delirium in older adults, Ontario's delirium quality standard, pocket guide for PSWs, and various handouts. 

    © 2022 Regional Geriatric Program of Toronto. 

  • Risk Factors and Signs of Depression – RNAO Table 4
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    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-dementia-and-depression

  • Senior Friendly 7 Toolkit
    Show description [+]

    The Senior Friendly 7 Toolkit supports clinical best practices for healthcare providers across the sectors of care and includes self-management tools for older adults and their caregivers. SF7 focuses on: delirium, mobility, social engagement, continence, pain, nutrition, and polypharmacy.

    https://rgptoronto.ca/resource/senior-friendly-7-complete-toolkit/

    © 2023 Regional Geriatric Program of Toronto.

  • SIGECAPS
    Show description [+]

    SIGECAPS is a mnemonic used to recall the most frequent symptoms of depression (prescription for energy capsules).

    Reference: adapted from "The patient who is depressed" in Psychiatry in Primary Care by Raymond W. Lam, (CAMH, 2019).

     

     

     

  • Six proven strategies to prevent delirium in older adults (poster)
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    This poster from the Regional Geriatric Program of Toronto reveals 6 strategies to prevent and manage delirium.

    Regional Geriatric Program of Toronto. (n.d.). Six proven strategies to prevent delirium in older adults. Retrieved from https://www.rgptoronto.ca/wp-content/uploads/2019/01/Delirium-prevention-PRINT.pdf

    © 2019 Regional Geriatric Program of Toronto. All Rights Reserved.

  • Six stratégies éprouvées pour prévenir le délire chez la personne âgée (affiche)
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    Cette affiche du Regional Geriatric Program de Toronto nous donne 6 stratégies pour prévenir et soutener le délire.

    Regional Geriatric Program of Toronto. (n.d.). Six stratégies éprouvées pour prévenir le délire chez la personne âgée. Récupéré de https://www.rgptoronto.ca/wp-content/uploads/2019/01/Delirium-prevention-PRINT-French.pdf

    © 2019 Regional Geriatric Program of Toronto. All Rights Reserved.

  • Substitute Decisions Act, 1992, S.O. 1992, c. 30
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    This Government of Ontario website contains the Substitute Decisions Act and Regulations that fall under it.

    Reference: Substitute Decisions Act 1992 Website: https://www.ontario.ca/laws/statute/92s30

  • Suggested Topics for Educational Programs for Nurses and Other Health-Care Providers – RNAO
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    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-dementia-and-depression

  • The Confusion Assessment Method (CAM)
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    The Confusion Assessment Method (CAM) is a standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately in both clinical and research settings. The CAM includes four features found to have the greatest ability to distinguish delirium from other types of cognitive impairment.

    https://geriatrictoolkit.missouri.edu/cog/Confusion-Assessment-Method-delirium.pdf

    The Hartford Institute for Geriatric Nursing, 2019. Donna McCabe, DNP, APRN-BC, GNP

    © 2003 Sharon K. Inouye, MD, MPH Inouye, S., van Dyck, C., Alessi, C., Balkin, S., Siegal, A. & Horwitz, R. (1990).

  • The Regional Geriatric Program of Eastern Ontario - Website
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    The RGP of Eastern Ontario is a coordinated network of specialized geriatric services, from hospital to home. Their clinical services, teaching and research are committed to optimizing the health and independence of seniors in the Champlain region. Website: http://www.rgpeo.com/en.aspx

  • This is Not My Mom – Information and Resources about Delirium
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    This site from Capital District health Authority, Halifax, Nova Scotia includes a vignette showing a daughter recognizing that her mother's behaviour has changed suddenly and therefore is not just related to her dementia. Delirium is described in the video and the site includes other information and resources for delirium.

    Reference: This is not My Mom Website: http://thisisnotmymom.ca/

  • Types of Dementia – RNAO Appendix E
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    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-dementia-and-depression

  • U-FIRST! - Website
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    U-FIRST! Is a proven and effective approach to working with people with dementia. Through dialogue and a case-based approach, learners will have more confidence in working with people with responsive behaviours. Training is especially designed for people working in community care, acute care and long-term care. For more information visit www.u-first.ca.  Permission to post obtained from Cathy Conway.

  • Understanding dementia (free on-line course)
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    The University of Tasmania, Australia, offers a free online course on Understanding Dementia. The course is delivered over 7 week, in order to obtain the most from this course, participants should expect to spend approximately 3 hours per week engaging with the course content and activities. 

    University of Tasmania. (n.d.). Understanding dementia. Retrieved from http://www.utas.edu.au/wicking/understanding-dementia

     

  • Urinary Tract Infections and Dementia
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    This resource highlights a treatment plan for an elderly person with a diagnosis of memory impairment who develops a urinary tract infection that results in delirium. 

    © 2022 Alzheimer's Society.

  • Use of Antipsychotics in Behavioural and Psychological Symptoms of Dementia (BPSD) Discussion
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    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.