Identifying the needs of dementia caregivers is critical for supporting dementia home care. This study identified a typology of expert interventions delivered to dementia caregivers during an innovative telehealth trial that used in-home video recordings to directly observe care challenges. Qualitative content analysis was used to analyze narrative notes describing interventions that were developed based on video data submitted by 33 caregiver–care recipient dyads. Two major themes emerged: education and skills for dementia care and caregiver support. Ten subthemes included education and skills related to: behavioral and psychological symptoms of dementia, disease expectations, safety, activities of daily living, medical care optimization, and medication utilization and caregiver support related to: respite, positive reinforcement, social and financial support, and self-care. Families providing in-home dementia care experience a wide range of care challenges. By using video data, dementia care experts were able to witness and evaluate challenging care situations and provide individualized feedback.

Using valid instruments to measure dyadic interactions and physical and social environment during mealtime care of persons with dementia is critical to evaluate the process, fidelity, and impact of mealtime interventions. However, the characteristics and quality of existing instruments remain unexplored. This systematic review described the characteristics and synthesized the psychometric quality of instruments originally developed or later modified to measure mealtime dyadic interactions and physical and/or social dining environment for people with dementia, on the basis of published reports between January 1, 1980 and December 31, 2020. We identified 26 instruments: 17 assessed dyadic interactions, one assessed physical environment, and eight assessed physical and social environment. All instruments were used in research and none in clinical practice. All instruments were observational tools and scored as having low psychometric quality, except for the refined Cue Utilization and Engagement in Dementia (CUED) mealtime video‐coding scheme rated as having moderate quality. Reasons for low quality are the use of small samples compared with the number of items, limited psychometric testing, and inadequate estimates. All existing tools warrant further testing in larger diverse samples in varied settings and validation for use in clinical practice. The refined CUED is a potential tool for use and requires testing in direct on‐site observations.

Background and Objectives A valid and reliable assessment of dementia dyadic communication and environment is essential to understand and facilitate social interaction and quality care. This review described the characteristics and evaluated psychometric properties of instruments that assess dyadic communication and environment between persons living with dementia and their caregivers. Research Design and Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline. Literature published until June 30 th, 2021, was searched. Ten psychometric properties and the ratio of sample size to the number of items were evaluated using the Psychometric Assessment for Self-report and Observational Tool. Results A total of 3,708 scholarly records was identified, and 24 eligible instruments from 48 scholarly records were evaluated. Twenty-two instruments assessed dyadic communication, and two assessed both dyadic communication and environment. Eighteen instruments were developed to assess task-related communication and fifteen for paid (professional) caregivers. All instruments were scored as low psychometric quality (score range = 0 - 7). Behavioral Observation Scoring System was scored the highest (total score = 7), followed by Dyadic Dementia Coding System, Grid for observation of physical and verbal behaviors of caregiver and resident, and Trouble-Indicating Behaviors and Repair (total score = 6, respectively). These instruments had low psychometric evidence for internal consistency, content validity, and structural validity. Discussion and Implications Existing instruments are in the early stages of development and validation in dementia population. Further testing is needed in diverse communication types in paid and unpaid dementia caregiver populations.

Background and Objectives It is critical to use validated instruments to diagnose and manage chewing and swallowing problems of persons living with dementia. The aim of this study was to synthesize the characteristics and psychometric quality of instruments that assess the chewing and swallowing abilities of persons living with dementia. Research Design and Methods The systematic review was used to conduct this study. We searched five electric databases for records published from January 1 st, 1980, to July 8 th, 2022. Records were eligible if they included any instrument to assess chewing ability or swallowing ability in dementia population. Eight characteristics of eligible instruments were extracted from the records: 1) development process, 2) operationalized concept/construct, 3) sample and setting, 4) administration method, 5) items, 6) scoring format/interpretation, 7) reliability, and 8) validity. The Psychometric Assessment for Self-report and Observational Tool was used to evaluate 12 psychometric properties of eligible instruments. Results In total, 11,074 records were reviewed. Thirty-five eligible instruments, including observational tools, self-report questionnaires, and physiological instruments, were identified from 60 records. All eight instruments assessing chewing ability were evaluated as having low psychometric quality, and only three out of 27 instruments assessing swallowing ability were evaluated as having moderate psychometric quality. Fifteen instruments were tested for only one type of psychometric property, limiting overall evaluation of psychometric evidence. Discussion and Implications The study findings inform the use and adaptation of appropriate instruments for practice and research. All existing instruments warrant further validation in larger samples to expand use in diverse care settings. This review described and evaluated current instruments measuring chewing and swallowing abilities and potential use in research and clinical practice to plan for and evaluate the effectiveness of mealtime and oral care practice and reduce health-related negative outcomes of persons living with dementia.