Generic Guidelines for Dementia Assessment - Dementia Outcomes ...

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CALD ISSUES • Use an interpreter when English is the second language and the participant agrees this is the correct course of action. • RUDAS is the preferred tool for CALD participants • How to manage the situation, when the rater has English as a second language, as well as the person being rated (neither share a first language). • How to manage a situation, which calls for an interpreter. How to work with an interpreter. (can take month(s) to organise an interpreter. • E.g. Spell world backwards. Feedback during assessment. Feedback to ‘patients’ during assessment should be neutral and, usually, should not indicate whether or not the response was correct. Appropriate comments as long as the ‘patient’ is trying: • “That’s fine” • “You’re doing well” If the ‘patient specifically asks whether or not they provided the correct response, accurate feedback can be given. Encouragement can be given, if the subject is nervous or giving up. Informant interviews: Accuracy depends on the informant used. Proxy reports are closer to personal reports when they provide information on usual behaviours as compared with rare or extreme behaviours. When using informants carefully consider potential biases and possible conflicts of interest. Interview the informant separate to the person being assessed. Away from the patient. Assessing individuals who have impaired ability to communicate (Kane & Kane, p. 486- 489.) Every attempt should be made to promote participation of the individual in their assessment – informant questionnaires are used when additional information is required or when the person is not able to participate meaningfully in the cognitive assessment. Neuropsychological assessment may also be required to ensure a valid assessment, particularly if capacity is being questioned. Time and cost challenge: Because each question may require more time due to potential impaired cognition, interviews are likely to take longer and result in more fatigue compared with cognitively intact older adults. Thus, it may be advisable to interview in two or more sessions as opposed to one long interview, particularly when multiple domains are being assessed. This, of course, adds to the cost
Granular Guidelines More excellent detailed guidelines for dementia assessment can be found in Professor S Banerjee’s DEMQOL Manual found on this site under “Quality of Life Measures”. Topics include the following: 1. Introducing a questionnaire: 2. Administering questionnaire items: 3. De-briefing after the interview: 4. Possible queries and responses - general: 5. Possible queries and responses – specific: Professor S Banerjee, Health Services Research Department, Institute of Psychiatry, Kings College, London.
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