Assessment of dementia in nursing home residents by nurses and assistants:criteria validity and determinants

Objectives To describe the criterion validity of nursing home staff's asses sment of organic disorder compared with ICD-10 criteria, and to identify de terminants of staff assessment of organic disorder Method TW hundred and eighty-eight residents were diagnosed using the GMS-A GECAT. Nursing staff members were interviewed about the residents' activiti es of Daily Living, behavioural problems, orientation in surroundings and c ommunication skills, and asked if the resident had an organic disorder. Mul tiple logistic regression was used to select the items that most strongly d etermined staff assessment of organic disorder. Results Sixty-two per cent of the residents were diagnosed by GMS-AGECAT as having organic disorder, 78% of these were correctly identified by the sta ff. Whether analysed among residents with or without organic disorder, or i n the total group of residents, the staff assessment of the presence of org anic disorder depended on a limited set of behavioural characteristics of t he resident, namely 'going to the toilet in inappropriate places', 'saying things that do not make sense' and impairment in orientation. Conclusion Staff comprehension of organic disorder resulted in over- as wel l as under-labelling of residents, a tendency that will affect communicatio n with medical personnel and may lead to inadequate or wrong medical treatm ent and to negative performance as well as negative role expectations in ev eryday life in nursing homes. Copyright (C) 2001 John Wiley & Sons, Ltd.