A Systematic Review of the Evidence for the Value of Functional Assessment of Older People with Dementia

There exists concern within the occupational therapy profession to demonstrate the efficacy of treatment through evidence-based practice (Bannigan 1997, Lloyd-Smith 1997, Taylor 1997). This is in keeping with other health care professionals who, equally, are addressing this issue (Muir Gray 1997). The clinical experience of the authors of this article suggests that occupational therapists are in a significant and powerful position when making decisions about the ability of someone with dementia to return to his or her own home. It is often the observations from a predischarge home assessment that are the determining factors for the discharge decision.

A systematic review of the current available evidence was carried out. This review highlighted that there was remarkably little evidence from the current occupational therapy literature in relation to people with dementia either to support or to refute the home assessment visit as the optimum method of assessing their ability to return home. The review demonstrated the need to undertake further evaluation and research into this key occupational therapy activity.

Validity of the nursing diagnosis of relocation stress syndrome

BACKGROUND

There have been no reports of validation studies on the nursing diagnosis of relocation stress syndrome (RSS).

OBJECTIVES

To validate the presence of some defining characteristics of RSS in a group of long-term care residents relocated en masse to a new facility.

METHODS

This study measured the effects of relocation on 106 elderly residents moved from one long-term care facility to another. The presence of five characteristics defining the nursing diagnosis of RSS (dependency, confusion, anxiety, depression, and withdrawal) were measured using the Multidimensional Observation Scale for Elderly Subjects (MOSES) scale, a tool previously validated for use among similar groups of individuals. Using the Chenitz model of relocation, measures were taken twice before and twice after the move to examine changes in these characteristics over time. No extraordinary efforts were made to alleviate RSS.

RESULTS

Repeated measures analysis of variance indicated no differences in the mean scores (p < 0.05) on these factors overall or from one measurement period to another.

CONCLUSION

On the basis of the findings from this research and supporting literature, the appropriateness of anticipating RSS during mass moves is questioned. Additional research with other measurement tools should be conducted to verify these results.