Recently, our facility is requiring us to stage dementia (early, mid, late). Following, Speech and OT are to role out a program to engage these patients in activities, according to their stage, in order to maximize the quality of life and keep them at the highest level of functioning. Since this is now a state law for Florida, I will be outlining the process as I go through it, for anyone else who is also in the process
For starters, it is most definitely a dignity issue to outwardly label one as early, mid, and late; therefore, I recommend using some more… abstract titles:
sun: early
moon: mid
stars: late
Our facility is requesting 2 screening methods. As this population can be tricky to assess, and when evaluating large numbers (our SNF is requiring everyone with a dementia dx be evaluated), I recommend the MoCA (Montreal Cognitive Scale) and the GDS (Global Deterioration Scale aka the Reisberg Scale). Better yet? Both are free! The MoCA also comes in formats for the blind ; for patients with severe aphasia, the SLUMS -aphasia version is available.
Lastly, and probably the most helpful thing I have found thus far, caregiver approaches and activities based on dementia stage, according to the GDS .
All in all, using methods of interviewing nursing, CNAs, family, etc. along with information gathered from the MoCA, we can determine the stage dementia successfully to help “families and caregivers understand the cognitive deficits and set realistic goals for living situations and therapy, as well as to maintain independence and improve quality of life for individuals with dementia” (Christos & Muir, 2010).
Stay tuned for more tips and information as this mission continues next week!
Thoughts: I encourage you to talk with the activities people in your facility. They are a wonderful referral source and may also be able to provide some ‘undiscovered’ activity resources!