Dr Margaret Walshe
Trinity College Dublin
Validation of the Profile for Communication Abilities in Dementia (P-CAD)
Health Research Board
Cognitive communication difficulties are an inherent part of dementia causing frustration, anxiety and misunderstanding not only for the person with dementia, but also caregivers and family. The importance of helping families to live well with dementia is emphasized by recent government policy documents. Speech and language therapists (SLTs) play a key role in helping people with dementia and their families to increase communicative competence, maximise communication ability and quality of life. However, unlike the UK and USA, SLTs in Ireland have no professional guidelines or policies on dementia. Care is thus fragmented. People with dementia are referred to the SLT late and often because of swallowing rather than communication difficulty. There is a perception that little can be done to help communication and SLTs lack valid reliable assessments that profile communication skills in dementia. Current tools focus on impairment and many are psychometrically unsound. The aim is to validate an assessment devised by the co-applicant. This tool, the Profile for Communication Abilities in Dementia (P-CAD) will give SLTs an instrument to profile communication difficulty and direct individualised advice, support and therapy from the outset. The P-CAD will be sensitive to changes in functional communication over time and provide an outcome measure to evaluate efficacy of SLT interventions. There are two phases to the study. Phase 1 seeks feedback on the P-CAD from user groups (caregivers, people with dementia, SLTs and other health professionals) and finalises the P-CAD. In Phase 2, the P-CAD will be trialled on 100 people with dementia and their caregivers. Results will be validated against cognitive and communication scales. Rater reliability will be examined. Finally, a valid reliable P-CAD will be available to SLTs. Its availability should inform individualised care pathways on communication abilities, encourage increased awareness of the SLT role and improve dementia care in Ireland.