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Home Assessment and Intervention Scale for Dementia: User Guide

Table of Contents​

  1. Before You Begin
  2. Assessment Procedure Steps
  3. Results Interpretation and Application
  4. Intervention Plan Implementation Guide
  5. Dietary Therapy Implementation Guide
  6. Progress Tracking and Reassessment
  7. Common Challenges and Solutions

Before You Begin​

Preparation​

Before using the scale, please ensure that you:

  • Choose a quiet, familiar environment for the assessment
  • Select a time when the patient's mental state is relatively good (usually between 9-11 AM)
  • Prepare paper and pen or print out the assessment form
  • Reserve 20-30 minutes of uninterrupted time
  • Maintain a relaxed and patient mindset if possible

Important Notes​

  • This scale is suitable for home use and requires no professional training
  • Assessment results are for reference only, not for diagnostic purposes
  • The purpose is to identify the most suitable home intervention methods
  • Avoid suggesting or leading the patient during assessment
  • Observe overall performance over 2-3 days, rather than a single moment

Assessment Procedure Steps​

Step One: Recording Basic Information​

First, fill in basic information such as assessment date, time, relationship between assessor and patient, patient's recent physical condition, and medication status.

Step Two: Item-by-Item Assessment​

The scale is divided into eight sections (A-H), assess each section in sequence:

  1. Section A: Language and Self-Expression Ability Assessment

    • Observe the patient's daily communication
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  2. Section B: Thinking and Problem-Solving Ability Assessment

    • Observe the patient's ability to handle daily problems
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  3. Section C: Memory Retrieval and Contextual Association Assessment

    • Observe the patient's ability to remember and understand contexts
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  4. Section D: Emotional Response and Social Behavior Assessment

    • Observe the patient's emotional expression and social interaction
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  5. Section E: Motor Coordination and Executive Function Assessment

    • Observe the patient's physical activities and operational abilities
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  6. Section F: Temporal Continuity and Self-Perception Assessment

    • Observe the patient's perception of time and self
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  7. Section G: System Integration Assessment

    • Observe the interaction between different functions
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

  8. Section H: Logical Association Assessment

    • Observe the patient's associative thinking ability
    • Choose descriptions that match actual performance
    • Multiple selections allowed, each selection scores 1 point

Step Three: Supplementary Observations​

In the "Supplementary Observations" section at the end of the assessment form, record:

  • Special circumstances during the assessment process
  • Items to which the patient responded particularly well or poorly
  • Any other observations you consider important

Results Interpretation and Application​

Score Calculation​

  1. Calculate the scores for each of the eight sections (A-H) separately
  2. Each section has a maximum score of 5 points (selecting all 5 descriptions)
  3. Higher scores indicate more significant dysfunction in that functional area

Identifying Primary Functional Impairment Areas​

  1. Identify the 2-3 sections with the highest scores
  2. These are the functional impairment areas that require priority intervention
  3. Record these functional impairment types in the "Score Result Analysis" table

For example:

  • Primary Functional Impairment Type 1: Memory and Contextual Understanding (Score: 4)
  • Primary Functional Impairment Type 2: Language Expression Function (Score: 3)
  • Primary Functional Impairment Type 3: Logical Association Ability (Score: 3)

Severity Reference​

  • 1-2 points: Mild impairment
  • 3-4 points: Moderate impairment
  • 5 points: Severe impairment

Intervention Plan Implementation Guide​

Finding Corresponding Intervention Recommendations​

  1. Find the corresponding primary functional impairment types in the "Home Intervention Recommendation Table"
  2. Read the specific intervention recommendations provided in that section
  3. Select 2-3 intervention measures that best suit your and the patient's situation

Developing an Intervention Plan​

  1. Arrange the selected intervention measures in a weekly schedule
  2. Assign appropriate frequency for each intervention measure (e.g., once daily, three times weekly)
  3. Consider the patient's energy and caregiver's time to avoid an overly intensive schedule

Environmental Preparation​

Based on the chosen intervention measures, prepare the necessary environment and materials:

  • Memory prompts
  • Activity materials
  • Environmental adjustments (such as reducing distractions, increasing lighting)

Dietary Therapy Implementation Guide​

Seven-Day Cycle Dietary Therapy Plan​

  1. Arrange daily meals according to the "Seven-Day Cycle Dietary Therapy Plan"
  2. Based on assessment results, prioritize dietary therapy days corresponding to the primary functional impairments
  3. Check existing ingredients at home and purchase necessary items in advance

Synergistic Food Combination Preparation​

Pay special attention to the preparation of "Synergistic Food Combinations":

  1. Key Combination 1: Turmeric Enhancement Formula

    • Mix in proportion: 0.5 teaspoon turmeric powder + a pinch of black pepper + 1 tablespoon olive oil
    • Use once daily, can be added to soups or rice

  2. Key Combination 2: Tea Polyphenol Enhancement Formula

    • Prepare 1 cup of green tea + 5 drops of lemon juice + a little honey
    • Drink 30 minutes after meals, 2-3 cups daily

  3. Key Combination 3: Cognitive Enhancement Formula

    • Prepare 20 blueberries + 5 walnuts + 10g (70%+) dark chocolate
    • Can be used as a morning or afternoon snack

  4. Key Combination 4: Choline Enhancement Formula

    • Use 2 egg yolks + 2 tablespoons olive oil + 2 cloves of garlic
    • Use as part of a main dish 2-3 times per week

Ingredient Substitution Guide​

If certain ingredients are unavailable, refer to the "Ingredient Substitution Guide":

  • Blueberries → Mulberries, blackcurrants, purple grapes
  • Salmon → Mackerel, sardines, cod liver
  • Quinoa → Brown rice, buckwheat, oats

Progress Tracking and Reassessment​

Progress Recording​

  1. Use the "Progress Tracking Form" to record intervention implementation
  2. Record observed changes at least once a week
  3. Pay special attention to recording positive changes, even if minor

Regular Reassessment​

  1. It is recommended to reassess using the same scale every 2-4 weeks
  2. Compare score changes across different times
  3. Observe which functional areas have improved or deteriorated
  4. Adjust the intervention plan based on the latest assessment results

Progress Interpretation​

  • Decreasing scores indicate functional improvement
  • Stable scores (especially in moderate to severe patients) are also positive results
  • Score fluctuations in the short term are normal, please focus on long-term trends

Common Challenges and Solutions​

Low Patient Cooperation​

  • Choose times when the patient's mental state is at its best for activities
  • Integrate interventions into daily life rather than obvious "training"
  • Start with activities the patient enjoys, gradually introducing others
  • Keep activities brief to avoid fatigue

Limited Caregiver Time​

  • Prioritize the most important intervention measures
  • Integrate interventions into daily activities (e.g., conducting language stimulation while preparing meals)
  • Consider inviting family members or friends to take turns participating
  • Use the "Caregiver Self-Care Guide" to avoid overexertion

Difficulties Implementing Dietary Therapy​

  • Start with a single synergistic combination and gradually expand
  • Combine dietary therapy with foods the patient enjoys
  • Prepare some ingredients in bulk in advance to reduce daily preparation time
  • Use seasoning methods to mask flavors the patient dislikes

Progress Not Evident​

  • Check whether intervention measures are being implemented according to plan
  • Consider adjusting activity difficulty (may be too difficult or too easy)
  • Reassess functional impairments and adjust intervention focus
  • Understand that sometimes stability without deterioration is also success

Remember, each dementia patient is a unique individual, and the scale and intervention recommendations need to be flexibly adjusted according to specific circumstances. Patience and persistence are keys to success, and even small progress is worth celebrating.

In case of emergencies or significant deterioration of symptoms, please contact healthcare professionals immediately