What is Dementia: DSQIID screening quetionnaire - Meaning and definition

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID)

Is a valid, reliable, and user-friendly observer-rated questionnaire, which is completed by carers of people with Down's syndrome for screening for dementia among these patients.

The DSQIID is divided into three parts.
Part 1. Asks about the “best”' ability the person has or has had.
Part 2. Contains 43 questions about behavior or symptoms that are usually associated with dementia in adults with Down's syndrome. Each item is scored on a four-point scale.
Part 3. Contains 10 questions, all of which are comparative; for example, "speaks (signs) less" and "seems generally more tired." Each question is scored with a yes/no response.

The 53 items cover areas such as loss of memory, confusion, loss of skills, social withdrawal, behavioral changes, psychological symptoms, physical symptoms, sleep disturbance, and speech abnormalities.

Deb S, Hare M, Prior L, Bhaumik S. Dementia Screening Questionnaire for Individuals with Intellectual Disabilities. The British Journal of Psychiatry 2007;190:440-444.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

The Abbey Pain Scale

Is an informant-based tool that attempts to measure pain in people with late-stage dementia.
Tool items:
1. Vocalization
2. Facial expression
3. Change in body language
4. Behavioral change
5. Physiological change
6. Physical change

Each item is leveled on a four point scale for severity.

Abbey J., Piller N, DeBellis A, Esterman A, Parker, D, Giles L, Lowcay, B. The Abbey Pain Scale. A 1-minute numerical indicator for people with late-stage dementia.Int J Palliat Nurs 2004;10(1), 6-13.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

The Assessment of Discomfort in Dementia (ADD)

The ADD focuses on evaluation of persons with dementia that may represent discomfort and encompasses physical, affective and social dimensions of pain.

Indicators of discomfort:
1. Facial expression: grimacing, frowning, blinking, tightly closed or widely open eyes, frightened, weepy, worried, sad
2. Mood: Irritability, confusion, withdrawal, agitation, aggressiveness
3. Body language: tense, wringing hands, clenched fists, restless,
rubbing/holding body part, hyper- or hypoactive, guarding body part, noisy
breathing
4. Voice: Moaning, mumbling, chanting, grunting, whining, calling out,
screaming, crying, verbally aggressive
5. Behavior: change in appetite, sleep mobility, gait, function, participation,
exiting, wandering, physically aggressive, socially inappropriate
or disruptive, resists care
6. Other

If potential pain behaviors are identified, the protocol consists of the following steps:
Step 1: Assessment of physical signs and symptoms
Sept 2. Current/past history of pain
Step 3. If steps 1 and 2 are negative, assess environmental press, pacing of activity/stimulation, meaningful human interaction, and intervene with non-pharmacological comfort interventions.
Step 4: If unsuccessful, medicate with non-narcotic analgesic per written order.
Step 5: If symptoms persist, consult with physician/other health professional or medicate with prn psychotropic per written order.

Kovach C, Noonan P, Griffie J, Muchka S, Weissman D. The Assessment of Discomfort in Dementia Protocol. Pain Management Nursing 2002;3(1),16-27.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

Doloplus-2

Is an observational pain assessment tool developed for the multidimensional assessment of pain in non-verbal elders who experience chronic pain.

There are three subscales with a total of 10 items:
1) Somatic reactions (5 items): somatic complaints, protective body postures adopted at rest, protection of sore areas, expression, sleep pattern
2) Psychomotor reactions (2 items): washing and/or dressing, ability
3) Psychosocial reactions (3 items): communication, social life, behavioral problems

Each of the 10 behavioral items is leveled with four descriptions of behaviors rated on a four point scale.

Lefebvre-Chapiro S: The Doloplus-2 scale–evaluating pain in the elderly. Eur J Palliat Care 2001;8:191-194. Torvik K, Kaasa S, Kirkevold O, Saltvedt I. Validation of Doloplus-2 among nonverbal nursing home patients - an evaluation of Doloplus-2 in a clinical setting. BMC Geriatrics 2010;10:9 .

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

Nursing Assistant-Administered Instrument to Assess Pain in Demented Individuals (NOPPAIN)

Is a nursing assistant (NA)-administered instrument for assessing pain behaviors in patients with dementia. This tool focuses on observation of specific pain behaviors while doing common care tasks. Pain is assessed at rest and with movement.

The tool has four main sections:
Section 1. Questions are asked about the caregiving situation: care conditions under which pain behaviors are observed such as bathing, dressing, transfers.
Section 2. The NA is presented with 6 pain behaviors with graphic illustrations: pain words, pain noises, pain faces, rubbing, bracing, restlessness. For each of these items the NA is asked: 1) if the behavior was observed (yes/no), and 2) to rate the intensity of the particular behavior on a 5-point numeric rating scale.
Section 3. The NA to mark the location of pain on a body schematic.
Section 4. The NA is asked to rate the patient’s global pain intensity on that day on a verbal descriptor scale (VDS) in the shape of a pain thermometer with 6 verbal pain descriptors.

Snow A, Weber J, O''Malley K, Cody M, Beck C, Bruera E. NOPPAIN: A nursing assistant-administered pain assessment instrument for use in dementia. Dementia and Geriatric Cognitive Disorders 2004;17(3),240-246.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 11, 2018.

The Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC)

Is a caregiver-administered pain assessment checklist using direct observation and familiar caregiver information for the assessment of pain in elders with limited ability to communicate.

There are four subscales with a total of 60 items:
Facial expressions (13 items)
Activity/body movements (20 items)
Social/personality/mood (12 items)
Physiological indicators/Eating and sleeping changes/Vocal behaviors (15 items).

Each item is scored on a dichotomous scale by checking off those pain behaviors that are observed. The number of checks on each subscale are added together and recorded and then these sums are added together for a total score.

Fuchs-Lacelle S, Hadjistavropoulos T. Development and preliminary validation of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Pain Management Nursing 2004; 5(2).

Dementia: DSQIID screening quetionnaire

To cite