Observed Affect in Nursing Home Residents with Alzheimer's Disease

Abstract

A method for assessing affect states among older people with Alzheimer's disease was developed for use in a study designed to evaluate a special care unit for such residents of a nursing home. The 6-item Philadelphia Geriatric Center Affect Rating Scale was designed for the use of research and other staff in assessing positive affect (pleasure, interest, contentment) and negative affect (sadness, worry/anxiety, and anger) by direct observation of facial expression, body movement, and other cues that do not depend on self-report, among 253 demented and 43 nondemented residents. Each affect scale was highly reliable, expressed in estimated portions of a 10-minute observation period when the affect expression occurred. Validity estimates were affirmative in showing discriminant correlations between the positive states and various independent measures of social and other outwardly engaged behavior and between negative states and other measures of depression, anger, anxiety, and withdrawal. Limited support for the two-factor dimensionality of the affect ratings was obtained, although positive and negative affect were correlated, rather than independent. Some hope is offered that the preference and aversions of Alzheimer patients may be better understood by observations of their emotional behaviors and that such methods may lead to a better ability to judge institutional quality.

The Assessment of Quality of Life in Dementia

“…Three approaches to the assessment of QOL can be distinguished: self-reports by the individual with dementia (e.g., Brod et al, 1999;Logsdon et al, 2002;., ZOOO), proxy reports by a family member or caregiver (e.g., Albert et al, 2000;Rabins et al, 1999), and direct observation of behaviors assumed to be related to QOL (e.g., Fossey et al, 2002;Lawton et al, 1996;Logsdon et al, 2002). Self-ratings will be influenced by education, memory, and attention problems.…”

“…Direct observation of behaviors believed to be associated with QOL has the advantage that it can be based on predefined behaviors and rated consistently over time. Evaluations of observed affect (Lawton et al, 1996(Lawton et al, , 2000 and pleasant events (Logsdon & Teri, 1997) have been proposed t o measure observable attributes of QOL. Limitations of this approach include uncertainty about whether what is being observed is what an individual considers t o be important to his or her QOL.…”

Efficacy of Theory-Based Activities for Behavioral Symptoms of Dementia

“…Affect was measured using the Philadelphia Geriatric Center Affect Rating Scale (ARS; Lawton, Van Haitsma, & Klapper, 1996). The observational scale has descriptive indicators for six affective states: pleasure, anger, anxiety, depression, interest, and contentment.…”

Reciprocal design: inclusive design approaches for people with late stage dementia

“…), and examples of indicators (possible bodily responses) that reflected these states (Kinney and Rentz 2005;Lawton, Van Haitsma, and Klapper 1996). Unlike many studies that use observation schedules, the design researchers in this study observed participants throughout the entire workshops (not for intermittent periods).…”