Dementia Care Principles Archives - DementiaHub.SG https://www.dementiahub.sg/dementia-practice/dementia-care-principles/ Singapore’s One-Stop Resource Portal on Dementia Tue, 24 Mar 2026 08:16:35 +0000 en-US hourly 1 https://www.dementiahub.sg/wp-content/uploads/2022/06/fav.png Dementia Care Principles Archives - DementiaHub.SG https://www.dementiahub.sg/dementia-practice/dementia-care-principles/ 32 32 What is Person-Centred Care? https://www.dementiahub.sg/dementia-practice/what-is-person-centred-care/ Fri, 06 Sep 2024 01:23:22 +0000 https://www.dementiahub.sg/?post_type=dementia&p=2395 Person-centred dementia care aims to enhance the wellbeing of persons living with dementia by meeting their psychological needs, which maintains personhood. Person-centred care (PCC) is a way of thinking about a person living with dementia and how to support them to enhance their quality of life. When caring for a person living with dementia, it is sometimes difficult to understand why a person behaves in the way they do, or make decisions related to the activities they should engage in.

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Person-centred dementia care aims to enhance the wellbeing of persons living with dementia by meeting their psychological needs, which maintains personhood.

An Introduction to Person-Centred Care

Source: Agency for Integrated Care

This video covers the five psychological needs which person-centred care aims to meet and shows scenarios of ways in which person-centred care can be applied.

What is PCC?

Person-centred care (PCC) is a way of thinking about a person living with dementia and how to support them to enhance their quality of life.

When caring for a person living with dementia, it is sometimes difficult to understand why a person behaves in the way they do, or make decisions related to the activities they should engage in.

PCC focuses on:

  • Seeing each person living with dementia as a person who
    • Is valuable
    • Has their unique history, routines, personal preferences, and needs
    • Experiences the world in their own way
    • Sees the social relationships that the person has as important for their wellbeing
  • Improving and taking care of the person’s level of wellbeing by taking care of these things.

This is different from the medical model of care, which:

  • Sees the person living with dementia as only a medical patient who requires treatment from healthcare professionals;
  • Focuses on keeping the person clean and safe from injury and harm;
  • Does not consider the person’s unique history, routines, personal preferences; 
  • Ignores the psychological needs of the person.

What is the goal of PCC?

To maintain personhood in the face of a person’s declining mental powers.

How is this goal achieved?

By meeting the 5 areas of psychological need that each person experiences.

Tom Kitwood’s Flower of Psychological Needs shows the needs that each person, including persons living with dementia, has. These needs are: Comfort, Attachment, Inclusion, Occupation, Identity, and Love.

While caring for persons living with dementia, we can aim to meet these needs.

What happens as these needs are met?

  • The person feels loved.
  • The person’s entire sense of self-worth will be enhanced.
  • The person will be more likely to experience a sense of personal control and empowerment.
  • There will be an improvement in the physical and psychological wellbeing of the person.

10 Key Principles of PCC according to Tom Kitwood

  1. A non-judgemental acceptance of the uniqueness of each person.
  2. Respect for the past experiences and learning of each person.
  3. Recognising the whole person as having emotional, social, physical and spiritual needs.
  4. Staying in communication requires flexibility, lateral thinking, and acceptance of other viewpoints.
  5. Nourishing attachments means ensuring people feel welcome and included.
  6. Creating a feeling of community gives us a sense of belonging, of where we fit in and what is expected of us.
  7. Maximising freedom for people to contribute to their care and eliminating unnecessary controls.
  8. Allowing ourselves to receive from others and valuing what they give (in other words, allowing the person with dementia to contribute in some way to the care environment, as far as they are able).
  9. Building and maintaining an environment of trust – protect from bullying, exploitation and other abuses of power.
  10. Focusing on positives – on people’s abilities and what they can do.

Person-Centred Care in Dementia by Alzheimer’s WA

Find out how to apply the person-centred care approach in everyday life with persons living with dementia.

Through this online course, you will learn about dementia and gain insights into its impact on individuals and caregivers, and how adopting a person-centred dementia care approach can enhance the wellbeing of persons living with dementia by meeting their psychological needs.

You can conveniently access the course from any device, including mobile phones and tablets, allowing you to learn at your own pace, anytime and anywhere.

Register for the Understanding the Psychological Needs of Persons Living with Dementia course here. 

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1. Why Do Behavioural Changes Happen?
2. Designing A Daily Routine

References

1. Kitwood, T. M. (1997). Dementia Reconsidered: The Person Comes First. Open University Press.

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]]> Person-Centred Care in Dementia https://www.dementiahub.sg/dementia-practice/person-centred-care-in-dementia/ Mon, 17 Oct 2022 18:19:25 +0000 https://www.dementiahub.sg/?post_type=dementia&p=12027 The term “person-centred care”, as a frequently-used term and a developing area,1 does not have a single agreed definition. When loosely defined, it has been used to refer to philosophies of caring that include goals that range from an emphasis on the dignity of the person being cared for, treating this person as an individual, ensuring that care is organised around the person, to involving the person and their close kin in their own care planning.2

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The term “person-centred care”, as a frequently-used term and a developing area,1 does not have a single agreed definition. When loosely defined, it has been used to refer to philosophies of caring that include goals that range from an emphasis on the dignity of the person being cared for, treating this person as an individual, ensuring that care is organised around the person, to involving the person and their close kin in their own care planning.2

Many of the person-centred care approaches within the dementia care field today draw from the work of Tom Kitwood’s seminal work on dementia care. Kitwood highlights that personhood and the relationships between the persons in question and others around them are the core of person-centred dementia care. Instead of historically dominant thought paradigms which claim that only neurological processes cause dementia, Kitwood emphasises that the social environment of the persons being cared for is a critical determining factor for the wellbeing of these persons, and the presentation of their neuropsychological conditions, according to the Enriched Model of Dementia, which will be detailed later in this article. The social environment concerns the way in which the cared-for persons are perceived by the persons around them, and consequently, the kinds of relationships that these persons have with them.

Because of the central role has played in the development of theory, practice, and history of person-centred dementia care, this article will begin by exploring the influences upon his work. Following this, the article will briefly describe a few prominent approaches to person-centred care as practiced in the dementia care field today, namely the Spark of Life approach, the Eden Alternative, and Dawn Brooker’s VIPS approach. 

Person-Centred Care from a Management Perspective

Source: Agency for Integrated Care

Stephen Chan (Care Services, Dementia Singapore) and Low Mui Ling (Peacehaven Nursing Home, Salvation Army) share about the importance of person-centred care and how it has benefitted care staff and clients/residents in dementia care settings.

A Short History of Person-Centred Care

The Influence of Carl Rogers’ Person-Centred Therapy

“Person-centred care”, as it is used in the field of dementia care, was drawn by Kitwood from the work of the American psychotherapist Carl Rogers,3 who developed and named the therapeutical approach known as person-centred therapy. Key characteristics of this approach include the assertions that people relating to the persons in question must be genuine (the condition of congruence), empathic, i.e., understand the client’s experience and perspective, and finally, have unconditional positive regard, that is, to approach the person with no judgment.4 These characteristics are apparent in the person-centred care approach of dementia care. 

Enriched Model of Dementia

The development of a biopsychosocial model of health, promoted by the American psychiatrist George Engel in the late 1970s,5 and incorporated into Kitwood’s Enriched Model of dementia, also contributes to the concept of person-centred care of dementia. In this model, dementia is a condition that should be understood from a view that takes into account the combined effects of biological, psychological, and sociological factors on the development of the condition of a person with dementia in an integrated way.6 

 

Prominent Person-Centred Dementia Care Approaches

Spark of Life Approach

The Spark of Life Approach, pioneered by Jane Verity, who had studied with Tom Kitwood, and co-developed by Hilary Lee, began as an interactive therapeutic social group programme called the Spark of Life Club Program, which aimed to provide an environment for persons with advanced dementia to experience rehabilitation and recover lost abilities. The programme was researched by Hilary Lee for her Master’s Degree, and further developed into a more extensive philosophy and programme for dementia care.7

Key points of focus of the Spark of Life approach are the quality of life of persons with dementia, and the belief that the recovery of abilities in a supportive and understanding social and emotional environment, termed as ‘rementia’, can occur.8

The Eden Alternative

The Eden Alternative, an approach towards person-centred care, was developed by geriatrician and nursing home physician William H. Thomas in 19919 response to what Thomas believed were the “three plagues of nursing homes: loneliness, helplessness, and boredom.”10 Its vision is described by principles known as the 10 Eden Alternative principles: 

The 10 Eden Principles

1. The three plagues of loneliness, helplessness and boredom account for the bulk of suffering among our elders.
2. A fulfilling life involves creating a human habitat with people of all ages and abilities (including children), plants and animals.
3. The antidote to loneliness is companionship.
4. The antidote to helplessness is the opportunity to give care as well as receive care.
5. The antidote to boredom is variety and spontaneity.
6. All activity must be meaningful to the person.
7. Medical treatment is not the only way.
8. People need to be able to make decisions for themselves.
9. Culture change is a never ending journey.
10. Wise leadership from all of us is essential.11

The Eden Alternative approach was developed for persons living in nursing homes, and specifically, for older persons. This approach is, in effect, also practiced in dementia care settings because of the large overlap between older persons living in nursing homes and persons with dementia.

Eden principles place a large emphasis on ensuring companionship and activity. In reflection of this emphasis, Eden facilities usually feature engagement with animals, children and youths, and the larger community, which the nursing home residents are encouraged to interact and build relationships with. According to research, interactions with children, youths, and animals may have significant impacts on home residents’ loneliness and feelings of helplessness,12 while connecting them relationally to the community around them. These initiatives support the dignity and social connectedness of Eden facility residents. 

The VIPS Perspective of Person-Centred Care

The psychologist Dawn Brooker’s approach to person-centred care in the dementia care context is defined as follows:

Person-centred care comprises four elements, which are

  • V for Valuing: Valuing people with dementia and those who care for them
  • I for Individuals: Treating people as individuals
  • P for Perspective: Looking at the world from the perspective of the person with dementia
  • S for Social Environment: A positive social environment in which the person living with dementia can experience relative wellbeing

This is otherwise expressed by the formula “PCC (person-centred care) = V + I + P + S”.13

Each element of VIPS is comprised of several smaller indicators. For example, Valuing people can be indicated by how well everyone in a care team or organisation knows what the team stands for (Vision), and the extent to which systems are in place to ensure staff know they are valued as a precious resource (Human resources).14  View a full list of the indicators that describe each element.

Care Cultures

Culture, according to different definitions, refers to information acquired from other individuals through social learning, such as by imitation or communication, that can affect an individual’s behaviours, according to the psychologist Steven Heine,15 or a historically transmitted pattern of meanings embodied in symbols by which people communicate knowledge and attitudes, according to the anthropologist Clifford Geertz.16 In these definitions of culture, information is learnt from others and historically perpetuated.

In the context of an organisation, organisational culture can be defined as “the assumptions shared by members of an organisation, used in their daily practice, and reinforced through providing successful solutions to problems faced in the course of work”.17 This means that the culture of an organisation that cares for persons with dementia is socially transmitted across generations of staff. Organisational culture has implications on the way persons with dementia are cared for in the long run, since the way the organisation cares for care recipients is heavily influenced by its culture, which does not easily change.

Person-centred care is one such culture. It both influences the thoughts and actions of care teams in a systemic way, and is perpetuated by what care teams think and do. For an organisation’s culture to sustainably change towards a person-centred culture of care, everything that can potentially influence the day-to-day culture of care should be addressed with an eye on the long term.18 This includes the environment of the organisation, the values of different levels of organisational staff, the communication patterns between staff teams and between staff and the persons with dementia, amongst other factors. 

Integrating Person-Centred Care Approaches With Local Approaches

It is also worth considering how existing cultural perceptions and worldviews in the place where person-centred care is being applied may affect the way person-centred care is received, and is integrated into care approaches, by persons being cared for, caregivers, organisations, and organisational staff. Each region, community, or organisation has a culture that differs slightly from others. In addition, in the Singapore context, organisational staff are from different cultural groups and nationalities. Studies have shown that a specific culture’s culture, context, and language can influence the adaptation of person-centred care related tools, such as the Person-centred Practice Inventory – Staff (PCPI-S).19, 20 This suggests that inter-cultural communication of person-centred concepts to organisational leaders and staff members needs to be done with an awareness of cross-cultural differences in order to ensure that there is both an accurate understanding of person-centred care, and consensus over how the organisation intends to proceed having understood this perspective of care.

Bringing Brooker’s VIPS person-centred care approach to dementia care into local contexts does not necessarily mean replicating a new model of care without continuing the care approaches inherent within an organisation’s culture and values already being practiced in that local context. Instead, care teams and organisations could consider their own vision and approach to care alongside the person-centred care approach, and decide the best course of action within a coherent value system. 

Measures of Person-Centred Dementia Care

Read Tools for Dementia Practice & Research for more information regarding measures of person-centred care, such as the Dementia Care Mapping 8th Edition, the VIPS Assessment Tool, and other tools. 

Strengths & Limitations of Person-Centred Dementia Care

A commitment to person-centred dementia care would require a consideration of its strengths, the evidence base for its efficacy in practice, and its challenges and limitations.

Empowerment of Persons With Dementia and Their Kin

A key strength of person-centred care is that it puts power in the hands of persons with dementia and their close kin. Apart from providing a moral imperative to care for persons with dementia by recognising the need to value their personhood, person-centred care approaches, by recognising the preferences, wishes, and unique identities of persons with dementia and their kin, also provides these persons with the power to shape their own care and their everyday lives.21 In addition, though persons with dementia may not have the ability or legal power to make decisions that require a higher level of mental capacity, a social- and health-care system characterised by person-centred care would involve close kin, such as caregivers, trusted family members, or legal attorneys, in important decisions regarding their personal matters. This allows care systems to, rather than treating care recipients as impersonal objects to operate on, instead work alongside these recipients as empowered partners involved their own care.22

A Focus on Systemic, Organisation-Wide Changes

In addition to highlighting the general need to provide care that places care recipients at the centre of care services, person-centred care approaches have also articulated the need for making systemic changes to care organisations by changing their care cultures. This focus on changing care cultures raises the probability that an organisation’s implementation of a person-centred care approaches will be sustained in the long-term.

Furthermore, by emphasising the need to empower organisations’ management and staff to work together to deliver care, person-centred approaches are in general comprehensive in describing how personnel practices are an important intervention point in the effort to align organisational culture with person-centred care. This is especially so because management teams set organisational values and vision, and staff require the support of management teams to execute their care.23 This detailed discussion on how organisations should deliver care to care recipients is a strength of person-centred care approaches.

Literature and Evidence Base on Person-Centred Care Approaches

The literature on person-centred dementia care approaches is currently developing alongside the field of person-centred dementia care practice. Currently, studies on person-centred dementia care have shown support for the effectiveness of these approaches.

In a 2019 systematic review of organisational-level implementation of person-centred care found that the quality of life of care recipients can be increased, and neuropsychiatric symptoms reduced, when this approach is implemented at an organisation-wide level with full support from organisation leaders.24 Another study involving a systematic review and meta-analysis of person-centred dementia care living in long-term care facilities and homecare settings found that the approach is able to reduce agitation, neuropsychiatric symptoms, and depression, while improving quality of life, though the learning and skill development of care personnel is needed for care recipients’ quality of life to be improved, and for effects on receipients’ behavioural problems to be sustainable.25 Finally, a cross-sectional study conducted in 7 nursing homes in Singapore, published in 2021, concluded that the overall level of person-centred care was positively associated with better resident well-being.26

There is a growing body of literature on ways to measure person-centred dementia care, which in turn is facilitating the quality and quality of literature and evidence on person-centred dementia care. For more information on measures of person-centred dementia care, find out at Tools for Dementia Practice & Research.

Cultural Differences

A challenge that teams that attempt to advocate person-centred dementia care faces is that it has to consider, as suggested in the earlier “care cultures” section of this article, the local cultures of the groups which the person-centred care approach will work with. Person-centred care approaches have an inherent value system and philosophy which may have differences with the values and thinking that the organisations, personnel, care recipients, caregivers, and local community-at-large may espouse. Communication and dialogue between the person-centred care advocates and the local community is encouraged to agree on and articulate the values and plans that the local organisation itself decides to proceed with.

Working With Different Organisations and Parties to Deliver Care

A challenge in implementing person-centred care is the necessity of working with different parties who may not work to deliver care in a person-centred way. For example, when a person with dementia and their care team face a care system or care personnel who may not be familiar with the care recipient due to rapidly changing staff or staff attrition, or because different service providers may not communicate or collaborate sufficiently, the care recipient will lose out on care quality. Wider cultural awareness on person-centred care, and discussions on best practice approaches for collaboration between different organisations to deliver person-centred care, may be necessary to meet this challenge.

Resource Constraints

Person-centred care is costly, although a necessarily costly investment in the valued lives of persons with dementia. To provide this care, finite resources including manpower, the state of the environment including physical facilities, and funding will need to be considered.

Implementing Person-Centred Dementia Care: Person-Centred Care Planning

In order to implement quality person-centred dementia care for persons diagnosed with dementia, care plans are formulated.

Care plans are extensions of medical records that are written records articulating care goals and action plans. They are living documents, that is, they are routinely reviewed and updated by care recipients, their next-of-kin, caregivers, and care professionals. Care plans aim to facilitate care that is individualised for these persons, coordinated across care teams, and well-documented.

For more information on person-centred care planning, find out at Person-Centred Care Planning. 

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References
  1. The Health Foundation. (2016, January). Person-centred care made simple. https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf 
  2. Ibid.
  3. Brooker, D. (2004). What is person-centred care in dementia?. Reviews in clinical gerontology, 13(3), 215-222.
  4. Murdock, N. L. (2017). Theories of Counseling and Psychotherapy: A Case Approach (4th ed.). New York: Pearson.
  5. The Health Foundation. (2016, January). Person-centred care made simple.
  6. Brooker, D., and Latham, I. (2016). Person-centred Dementia Care: Making Services Better with the VIPS Framework (2nd ed.). Jessica Kingsley Publishers.
  7. History of the spark of life model of care. Retrieved February 22, 2021, from https://dementiacareinternational.com/history-spark-life-philosophy/
  8. Barback, J. (2014, March 10). Spark of life approach: is it the way to go? Healthcentral.nz. 
  9. Brune, K. (2011). Culture change in long term care services: Eden-Greenhouse-Aging in the community. Educational Gerontology, 37(6), 506-525.
  10. Thomas, W. H. (1996). Life worth living: How someone you love can still enjoy life in a nursing home: The Eden Alternative in action. Publisher: Vanderwyk & Burnham.
  11. Alzheimer’s WA. (n.d.). Models of Care. https://www.alzheimerswa.org.au/about-dementia/understanding-dementia-care/models-of-care/
  12. Brune, K. (2011). Culture change in long term care services: Eden-Greenhouse-Aging in the community. Educational Gerontology, 37(6), 506-525.
  13. Brooker, D., and Latham, I. (2016). Person-centred Dementia Care: Making Services Better with the VIPS Framework (2nd ed.). Jessica Kingsley Publishers.
  14. Ibid.
  15. Heine, S. J. (2010). Cultural psychology. In S. T. Fiske, D. T. Gilbert, & G. Lindzey (Eds.), Handbook of social psychology (p. 1423–1464). John Wiley & Sons, Inc. https://doi.org/10.1002/9780470561119.socpsy002037
  16. Geertz, C. (1973). The interpretation of cultures (Vol. 5019). Basic books.
  17. Brooker, D., and Latham, I. (2016). Person-centred Dementia Care: Making Services Better with the VIPS Framework (2nd ed.). Jessica Kingsley Publishers.
  18. Ibid.
  19. Balqis-Ali, N. Z., San Saw, P., Jailani, A. S., Fun, W. H., Saleh, N. M., Bahanuddin, T. P. Z. T., Sararaks, S., & Lee, S. W. H. (2021). Cross-cultural adaptation and exploratory factor analysis of the Person-centred Practice Inventory-Staff (PCPI-S) questionnaire among Malaysian primary healthcare providers. BMC Health Services Research, 21(1), 1-12.
  20. Bing-Jonsson, P. C., Slater, P., McCormack, B., & Fagerström, L. (2018). Norwegian translation, cultural adaption and testing of the Person-centred Practice Inventory–Staff (PCPI-S). BMC health services research, 18(1), 1-10.
  21. Poland, F., & Birt, L. (2016). The agentic person: shifting the focus of care.
  22. Pulvirenti, M., McMillan, J., & Lawn, S. (2014). Empowerment, patient centred care and self‐management. Health Expectations, 17(3), 303-310.
  23. Chenoweth, L., Stein-Parbury, J., Lapkin, S., Wang, A., Liu, Z., & Williams, A. (2019). Effects of person-centered care at the organisational-level for people with dementia. A systematic review. PloS one, 14(2), e0212686.
  24. Ibid.
  25. Kim, S. K., & Park, M. (2017). Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis. Clinical interventions in aging, 12, 381.
  26. Tew, C. W., Ong, S. P., Yap, P. L. K., Lim, A. Y. C., Luo, N., Koh, G. C. H., Ng., T.P., & Wee, S. L. (2021). QUALITY OF LIFE, PERSON-CENTRED CARE AND LIVED EXPERIENCES OF NURSING HOME RESIDENTS IN A DEVELOPED URBAN ASIAN COUNTRY: A CROSS-SECTIONAL STUDY. Jour Nursing Home Res, 7, 1-8.

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]]> Tools for Dementia Practice and Research https://www.dementiahub.sg/dementia-practice/tools-for-dementia-practice-and-research/ Thu, 29 Sep 2022 05:44:38 +0000 https://www.dementiahub.sg/?post_type=dementia&p=5441 With the rising incidence and prevalence of dementia worldwide that is projected to continue, more efforts have been invested to address the needs of persons living with dementia and individuals around them. One such effort is the development of assessment tools and instruments in the field of dementia care.

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With the rising incidence and prevalence of dementia worldwide that is projected to continue, more efforts have been invested to address the needs of persons living with dementia and individuals around them. One such effort is the development of assessment tools and instruments in the field of dementia care.

Some uses of the assessments include:

  • Measuring the progress of dementia-related impairments (cognitive, functional), or
  • Measuring the effects of dementia treatments in clinical trials, and
  • Evaluating the impact of psychosocial interventions in enabling persons living with dementia to live well, amongst other assessments.1

Other than studying dementia assessment tools and instruments, researchers and clinicians also study the reliability and utility of the methods for validating and reporting dementia assessment tools and instruments. An ideal measure should be valid, reliable and practical to use. It should not use too much of the assessors’ and participants’ time.

In addition, as dementia may, from its earliest stages, affect cognition and language abilities, it is important to have both persons living with dementia and their proxies, such as family caregivers and care professionals, involved in the assessment process.2 All these factors should be taken into consideration when choosing an assessment or instrument to be used in dementia care and research.

Singapore’s Ministry of Health (MOH) has developed a set of Clinical Practice Guidelines on Dementia. These guidelines list a number of recommended assessment tools to be used for cognitive screening, ratings of behaviour changes, and assessment of functional status and of social issues for persons at risk of dementia, for the process of diagnosis, and for persons who have been diagnosed with dementia.3

In the following nine documents, studies of some existing measures in dementia care have been consolidated and organised according to the purposes, strengths and limitations, and psychometric properties of the measures. You can find the embed links to the original journal articles and assessments/instruments in these articles for your further reading.

Tools & Resources

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Measuring Person-centredness of Care

Person-centred Care (PCC) is a philosophy that views individuals using healthcare and social services as equal partners in planning, developing, assessing, and monitoring care to ensure it meets their needs.

This resource lists and provides information about existing measures of PCC in the context of dementia care.

These measures include the Dementia Care Mapping tool, VIPS Assessment Tool, and Person-Directed Dementia Care Assessment Tool. 

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Cognitive Assessments and Screening Tests

This resource lists and provides information about cognitive assessment and screening tools. These tools are used to both identify individuals showing symptoms of dementia and to monitor the progress of cognitive deterioration.

These measures include the Singapore version of the Abbreviated Mental Test (AMT), the Mini Mental State Examination (MMSE), and the Singapore version of the Montreal Cognitive Assessment (MoCA).

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Measures for Stages of Dementia

Dementia is a progressive condition, and in the field of dementia care, there are different systems available to measure, describe, and classify the progress of an individual person’s condition.

This resource lists scales that both measure aspects of a person’s condition and classify the progression of their condition into stages in their classification systems.

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Measures for Basic and Instrumental Activities of Daily Living (ADLs)

Basic and instrumental activities of daily living (ADLs) are tasks one must perform to function in everyday life. This resource lists and provides information about tools used to measure the degree to which a person can perform everyday tasks. Some of these tools are designed for use with persons living with dementia, and some for use beyond this specific population.

The scales listed include the Bristol Activities of Daily Living Scale (BADLS), Shah Modified Barthel Index (MBI), and Pool Activity Level (PAL) Checklist.

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Pain Measures for Persons with Advanced Dementia

This resource lists observational pain measures (pain measures that require observing a person’s behaviour) that are more appropriate for persons with limited communication abilities.

These include the Abbey Pain Scale, Non-Communicative Patient’s Pain Assessment Instrument (NOPPAIN), and the Checklist of Nonverbal Pain Indicators (C.N.P.I.).

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Measures for Behaviour Changes

Behaviour changes often happen as the condition of the person living with dementia changes. Some common changes in behaviour observed as dementia progresses include sleep disturbances, repetitive speech or actions, or a loss of behavioural inhibitions.

This resource lists and provides information about instruments used to assess behaviour changes in the field of dementia care. 

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Measures on the Quality of Life of Persons Living with Dementia

This resource lists instruments used in the field of dementia care to measure the quality of life of persons living with dementia, or instruments used to measure constructs related to quality of life.

These instruments include the Dementia Care Mapping (DCM) tool, the Bradford Well-being Profile (WBP), the Bath Assessment of Subjective Quality of Life in Dementia (BASQID), and the Dementia Quality of Life Measure (DEMQOL).

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Measures on Dementia Caregiving

This resource lists and provides information about existing measures of various aspects of caregiving, including caregiver stress, caregiver burden, caregiver gains, the meaning caregivers find through caregiving, caregiver competence, and caregiver self-care self-efficacy, in the context of dementia care.

These measures include the Gain in Alzheimer care INstrument (GAIN) scale, the Short Form Zarit Burden Interview (ZBI-12), and the Sense of Competence Questionnaire.

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Measures on Dementia Attitudes & Knowledge

This resource lists and provides information about measures of attitudes that persons in general have towards dementia and what they know about the condition.

These measures include the Dementia Attitudes Scale (D.A.S.), Dementia Knowledge Attitude Scale (D.K.A.S.), and Knowledge in Dementia (K.I.D.E.) Scale.

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Reference

1. Burns, A., Lawlor, B., & Craig, S. (2002). Rating scales in old age psychiatry. The British Journal of Psychiatry, 180(2), 161–167. https://doi.org/10.1192/bjp.180.2.161

2. Sheehan, B. (2012). Assessment scales in dementia. Therapeutic Advances in Neurological Disorders, 5(6), 348–358. https://doi.org/10.1177/1756285612455733

3. Singapore Ministry of Health. (2013, July 10). Dementia: MOH Clinical Practice Guidelines 1/2013. Person-directed dementia care assessment tool. https://www.moh.gov.sg/docs/librariesprovider4/guidelines/dementia-10-jul-2013—booklet.pdf

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