Palliative assessment in dementia Pa Pain Depressi ssion Anxi - - PowerPoint PPT Presentation

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Palliative assessment in dementia Pa Pain Depressi ssion Anxi - - PowerPoint PPT Presentation

Dec 11, 2022 409 likes •702 views

Palliative assessment in dementia Pa Pain Depressi ssion Anxi xiety Psyc sychosi sis De Deliriu lirium DI DIST STRESS ESS Rule 1 All observed behavior is a normal reaction to an abnormal situation. Rule 2 Treat the

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Palliative assessment in dementia

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Pa Pain

Depressi ssion Anxi xiety Psyc sychosi sis De Deliriu lirium DI DIST STRESS ESS

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Rule 1

  • All observed behavior is a normal reaction to an abnormal situation.
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Rule 2

  • Treat the symptoms and adapt the situation, Do not ‘treat’ behaviour.
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Rule 3

  • All observed behavior is a normal reaction to an abnormal situation.

Your job is to establish what the abnormal situation is…..

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Challenges of assessment

  • Understanding of symptoms.
  • Communication.
  • Getting investigations.
  • What does the person with dementia want?
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Does the person with dementia understand their situation?

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Is this investigation going to change the potential

  • utcome?
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Have decisions already been made?

  • Power of Attorney.
  • Advanced decision.
  • Advanced statements.
  • Collateral.
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Assessment Tools

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Questionnaire Informant Observational

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Abbey pain scale, Doloplus-2 NOPPAIN, PAINAD, PACSLAC

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Depression:

  • Geriatric Depressions Scale
  • Cornell Scale for Depression in

Dementia Anxiety:

  • The Worry Scale
  • RAID
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Psychosis:

  • Neuropsychiatric Inventory
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Patient Collateral Investigations Observation Assessment tools

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Theory Experience

Best Guess

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Treatment ladder

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Agitated Aggressive Behaviourally disturbed

Distressed

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  • Disability Distress assessment

Tool – DissDAT

  • Discomfort Scale – Dementia in

Alzheimer’s type - DS-DAT

  • Distress Recognition Tool - DRT
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Finally…… Don’t forget rule 1

  • All observed behavior is a normal reaction to an abnormal situation.
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georgecrowther@nhs.net