Recommendations to Deliver Person-Centered Long-Term Care for Persons Living With Dementia.

Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality. These 2 themes are intimately related: the dementia care workforce's capacity cannot be improved until care processes and outcomes that are significant to PCC are explicated. The LTSS workforce needs training in PCC as well as pragmatic measures to assess the quality of the care they provide. We conclude with several recommendations for future policy and practice-oriented workforce research

Challenges of observing mood in people with severe dementia

Ten long term care residents who were known to walk excessively and enter the private space of others participated in a three week trial that involved listening to a selection of their preferred music for 20 minutes daily. During the intervention, mood was observed (n=92 observations) in real time using Noldus Pocket Observer, a software package traditionally used to code behaviour from video footage. We used Lawton’s Modified Mood Scale to classify positive (interest, pleasure, joy), neutral and negative (sadness/depression, anxiety/fear, anger) mood. Rhythmic movement and happy tears were added to the positive mood state to capture anticipated mood associated with listening to music. During the intervention, positive mood was observed 58%, neutral mood 32% and negative mood 10%, of the time. Despite utilising gold standard methodology for training observers to recognise the nine mood states, and observers achieving 100% recognition in post training testing, the inter rater reliability (IRR) (n=11 observations) for observing the subtle categories of nine mood states the variability in duration of mood ranged from 6% to 11%, with interest and rhythmic movement having the greatest disparity. When the observations were coded for broader categories of positive, neutral and negative mood, the disparity in mood duration between observers was only 1-2% within categories/ across all categories. While the findings were not significantly different, this experience suggests that recognising and coding mood observation in older people with dementia beyond broad categories can be challenging during real time observatio