Dementia-patients (Reisberg GDS, 5, 6 or 7) with symptoms of pain and/or challenging behavior (measured with MDS-pain, PACSLAC-D, NPI-NH and CMAI).
Conditions
Interventions
In 5 meetings of 4 hrs each, nurses and nursing home physicians of all experimental wards are trained in the use of the steps in the protocol. The training is given by two collaborating, experienced t
2. The SECOND step is to perform a needs assessment that focuses on affective needs of people with dementia
3. The THIRD step concerns a trial of non-pharmacological comfort interventions
4. The FOURTH step is a trial of analgesics
5. STEP FIVE refers to consultation of other health care professionals or practitioners, or a trial of psychotropic drugs.
Sponsors
- VU University Medical Center (Department of Nursing home medicine)
- EMGO+ Institute of Health and Care Research
Eligibility
Inclusion criteria
Inclusion criteria: 1. Global Detoriation Scale (Reisberg 1983), (GDS) > 5; 2. No chronic psychiatric diagnosis other than dementia; 3. CMAI > 44, NPI > 4, MDS-pain = pain. In all included residents: 1. PACSLAC-D (pain observations); 2. Depression (Cornell and MDS-depression); 3. Quality of Life (Qualidem); 4. ADL (Katz); 5. Co-morbidity (ICD-10); 6. Demographics; 7. Apo-E4 (Buccal mucosa swab).
Exclusion criteria
Exclusion criteria: 1. GDS-score < 5; 2. Chronic psychiatric diagnosis other than dementia.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain: measured with painscale of the Dutch version of the MDS-RAI and PACSLAC-D Behavior: CMAI, NPI-NH. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Depression: Cornell-depression and MDS-DRS; 2. Quality of Life: Qualidem; 3. Use of anti-psychotic medication. | — |
Contacts
Public ContactM.J.C. Pieper
Department of Nursing home medicine and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam van der Boechorststraat 7, Room B-544
Outcome results
None listed