September 2001

From McGill University

New home-safety assessment scale for people with dementia living at home

In Canada, 8% of senior citizens aged 65 and over suffer from Alzheimer's disease or from another form of dementia. In Quebec, 5.6% of these people live at home, and one-third of those live alone. Most of them do not want to live elsewhere, although the progressive loss of their memory increases the risk of an accident in their home. Burns, falls, malnutrition and mistakes with medication are some of the consequences. As most caregivers know, there is nothing more subjective than the assessment of risk, even when one has considerable experience working with senior citizens.

" Health professionals have long wished for an objective way of evaluating the dangers incurred by people with memory and cognitive deficits living alone at home," says Dr. Louise Poulin de Courval, McGill Professor of Family Medicine, family doctor and researcher at the CLSC Côte-des-Neiges. Poulin de Courval led a pan-Canadian team of researchers with whom she designed, tested and validated the first "Home-safety Assessment Scale for Peopl;e with Dementia Living at Home" (S.A.S.).

Over the last three years, she has worked in cooperation with health professionals responsible for the delivery of home care programs in CLSCs, daycare centres and hospitals in Quebec, Alberta and British Columbia. The SAS was tested and validated among 175 patients in English and French, in both urban and rural areas.

"Thanks to the SAS," says McGill neurologist Serge Gauthier, an expert in Alzheimer's disease and a member of Dr. Poulin de Courval's research team, "physicians, nurses, family helpers, social workers, physiotherapists and occupational therapists can now evaluate in a few minutes the risks of accidents in any particular home."

The assessment scale has nothing to do with a check-list. As Dr. Poulin de Courval explains, "Whether answering the 32 questions of the scale's long version, or the 19 questions of the abridged version, caregivers ponder their answers. When, for example, they are asked ' is this person alone at home,' by ticking their choice of ' Always, Most of the time, Occasionally, or Never,' they necessarily assess the risk incurred."

Finally, when comparing their results, caregivers can intervene to diminish the risks. Thanks to the new SAS tool, they now have a publicly-available instrument which will allow them to determine precisely the level of care and services needed to make sure that the highest number of people with memory and cognitive deficits can safely stay at home for a longer period of time, if they want it.

The Safety Assessment Scale is available online at www.clsccote-des-neiges.qc.ca/sas.











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