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Table 14 Content of the IdA® and the guiding questions (Version 3)

From: Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia

Dimension Guiding questions Content of dimension
Part 1 Description of the behaviour
 Assessment of challenging behaviour Which type of challenging behaviour is observed? Naming and description of the behaviour; description of the circumstances under which the behaviour occurs; quantification of behaviour; denomination of the consequences of the behaviour
Part 2 Capturing the triggers of the behaviour
 Cognitive status Could the challenging behaviour be explained by the type or stage of dementia?
Could the identified cognitive impairments explain the challenging behaviour?
Events from the past, information about oneself, present living situation, sense of time, orientation in important rooms, complete activities, recognition of important everyday items, recall of information received a day or less before, recognition of important everyday items
 Physical health status & discomfort Could the identified physical impairment or discomfort somehow be related to the challenging behaviour? Mobility, fluid and food intake, excretion functions, sleep, vital physical functions, depression, pain, delusions/hallucinations, medications with adverse side effects
 Independence in everyday life Could the identified stressful/burdening dependencies in everyday life activities have provoked the challenging behaviour? Emotional burden/stress of care dependencies and care interventions
 Communication Could the identified comprehension/communication difficulties have triggered/provoked the challenging behaviour? Is it possible that the behaviour itself presents a form of communication and to explain the behaviour accordingly? Hearing/seeing well, language of communication, comprehensibility of speech, quality of verbal communication, understanding of verbal/written communication, contact with others, communication of personal wishes/desires
 Personality & lifestyle before the onset of dementia Could the challenging behaviour be an expression of the resident’s personality? Could the challenging behaviour be related to past life events or the person’s former lifestyle? Could the challenging behaviour be a reaction to stress? Personality before the onset of dementia, stress tolerance, frustration tolerance, management of stressful situations before dementia;
Events connected with negative emotions or threatening events, events associated with positive impact/emotions, leisure time before the onset of dementia, occupation, daily rhythm/daily rituals with unique importance
 Mood & emotions Could the challenging behaviour be an expression of certain moods and emotions?
Could the challenging behaviour serve as self-stimulation?
Fear, tiredness/exhaustion, closer relationship to the resident, relationship showing confidence, safety, times without occupation, boredom, occupational activities/leisure time activities/structure of the day not matching the residents´ personal preferences
 Environmental influences Could the challenging behaviour be related to certain environmental characteristics?
Could the challenging behaviour be related to a lack of sense of security and familiarity?
Could staff structure have an impact on the challenging behaviour?
Lighting, noise in the surroundings, smells, furnishing, privacy, contact with others, positive stimuli/stimulations, preference of caregiver, continuity of primary caregivers