Activities of daily living and cognitive levels of function in dementia

Abstract

The number of progressive dementia patients being caredfor in long term institutions is increasing. As medical science continues to search for answers to treatment and cure, caregivers continue to struggle with managing cares and promoting patient dignity. Evaluation and identification of individual patient cognitive assets and limitations is essential in planning patient cares. The purpose of this study is to describe two tools, used in a team aproach, to facilitate managing basic daily cares. The study compares the scoring of the two tools indicating a substantial relationship between the two instruments and suggests that the Cognitive Performance Test (CPT) and the Self Care Performance Test (SCPT) rate behavior and task performance in a consistently similar manner. The results suggest that the scales are an accurate predictor of demented patients cognitive abilities and limitations and can facilitate designing nursng care plans. The CPT(which can be given in about 20 minutes) can be completed upon admission, the test score shared with nursing and the SCPT can guide plans of care. Cares planned in this manner are likely to allow the patients independence in performing those cares they are capable of and not frustrating them by expecting them to perform skills they have lost.

This study focuses on patients in the later stages of progressive dementia. Fifty-eight subjects were rated using the two tools. Fifty-one of the 58 subjects in the study received a rating level offour or lower. (Allen 's levels of rating progressive dementia with level six being normalfunctioning.) Patient scores for both the CPT and the SCPT are based on observance of performance and do not require verbal responses and therefore lower level dementia patients can be more reliably rated.