1. Leslie Udell Program Co-ordinator Winnserv Inc.
Aging in Place - A Strategy for Caring for People with Intellectual Disability and Dementia
Partners in Care… Living in the Moment
March 6, 2007
Leslie Udell
Program Co-ordinator
Winnserv Inc.

2. Degree of Commitment to Supporting Individuals
Educating Board of Directors
Development of agency policies
Recruitment and education of new board members

3. Accessible/Dementia Friendly Housing
Environmental considerations
Evaluating current housing
Considerations for people living in apartments or on their own

4. Admission and Discharge Criteria
Dealing with individual’s actions and reactions to the symptoms of Alzheimer’s disease
The impact of significant health concerns
Supporting people who have the need to wander
Supporting people who are living independently
Considerations for a death at home

5. End of Life Care Policies
Benefits and steps to planning ahead
Planned death at home
Advanced Care Directives, DNR orders
Funeral planning
Bereavement support

6. Assessment Documentation of decline
Gradual onset and continuing cognitive decline
Atypical actions and reactions
Late onset seizure activity

7. Diagnosis and Misdiagnosis
Detailed medical history
Thorough physical and neurological exams
Psychiatric examination
Pharmacological review

8. Assessment Tools Videotaping Vineland Adapative Behavior Scales
Inventory for Client and Agency Planning (ICAP)
Scales of Independent Behavior
Adaptive Behavior Scale – Residential and Community

9. Specialized Dementia Scales
Dementia Scale for Down Syndrome (DSDS) -Gedye
Dementia Questionnaire for Mentally Retarded (DMR) – Evenhuis et al.
Assessment for Adults with Developmental Disabilities (A.A.D.S.) – McQuilliams, Kalsy, Oliver & Hall &
Generic Tools - Mini Mental

10. Change in Focus of Supports Provided
Maintaining skills
Stabilizing the environment
Minimizing choices
Giving reassurance
Personal care
Assessing and meetings medical needs
Meaningful activities

11. Supporting Families Provision of information
Planning and directing care plans
End of life decisions
After the death

12. Staff Levels and Training
Appropriate levels of staffing
Dementia specific training
Maintaining and preserving skills vs. learning new skill
Pain recognition and management
Addressing concerns about reactions and actions related to the disease
End of life care, the dying process and grieving for themselves and roommates

13. Provision of Personal Care
Body mechanics
Use of equipment
Assistance for eating and drinking
Issues of incontinence

14. Support for Grieving and End of Life Care
Support teams for staff and roommates
Pastoral care for families, staff and roommates
Staff discussions around their beliefs and concerns
Families values and beliefs around death and dying
Utilizing hospice and palliative care
Arrangements for final farewells

15. Disclosure of Diagnosis
Do you tell the person that they have dementia?
Consideration of policies on disclosure
Do you tell roommates about the diagnosis?

16. Understanding the Disease
How do you explain Alzheimer’s disease to the individual and their friends and roommates?
Fostering acceptance and addressing concerns

17. Death, Dying and Grieving
Rituals
Repeated grieving
The many faces of grief