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Home-Based Dementia Assessment and Intervention Scale

Scale Overview​

This scale has been developed based on advanced cognitive science theories and clinical data mapping, now adjusted as an integrated cognitive function assessment framework. It aims to help caregivers understand the core functional impairment types in dementia patients and provide targeted home-based intervention recommendations. This assessment theory considers that the human cognitive system is composed of multiple interrelated functional areas, including language expression, cognitive execution, memory function, emotional regulation, motor coordination, etc. Different dementia patients may have impairments in different functional areas, requiring different types of intervention.

Instructions for Use​

  • This scale is suitable for home use and requires no professional training
  • Assessment time: 15-20 minutes per session
  • Recommended frequency: Assessment every 2-4 weeks
  • Scoring method: Independent scoring for each section, select the most fitting description for the patient (multiple selections allowed)
  • Purpose: To find the most suitable home intervention methods, not for diagnostic purposes

Assessment Scale​

A. Language and Self-Expression Ability (Language Expression Function Assessment)​

___ 1. Speech content is frequently incoherent or cannot find appropriate words
___ 2. Difficulty expressing own needs or feelings
___ 3. Cannot use language to describe past events
___ 4. Weak response to topics related to themselves
___ 5. Frequently confuses pronouns (I, you, he/she)

Score: Section A total ____points (1 point for each selected item)

B. Thinking and Problem-Solving Ability (Cognitive Executive Function Assessment)​

___ 1. Difficulty solving simple daily problems
___ 2. Cannot complete multi-step tasks in sequence
___ 3. Obviously impaired judgment (such as dressing inappropriately for the occasion)
___ 4. Difficulty adapting to new situations
___ 5. Difficulty understanding cause-and-effect relationships

Score: Section B total ____points (1 point for each selected item)

C. Memory Retrieval and Contextual Association (Memory and Contextual Understanding Assessment)​

___ 1. Obviously declined recent memory, but can recall when reminded
___ 2. Often cannot recognize the purpose of familiar objects
___ 3. Easily forgets ongoing activities
___ 4. Needs repeated reminders of daily activity steps
___ 5. Gets lost or confused in familiar environments

Score: Section C total ____points (1 point for each selected item)

D. Emotional Response and Social Behavior (Emotional and Social Function Assessment)​

___ 1. Large emotional fluctuations, reactions may be inappropriate for the context
___ 2. Flat or unnatural emotional expression
___ 3. Weakened emotional response to family members
___ 4. Reduced or inappropriate social interaction
___ 5. Easily irritable or overly sensitive

Score: Section D total ____points (1 point for each selected item)

E. Motor Coordination and Execution Ability (Motor Coordination Capability Assessment)​

___ 1. Unsteady walking or prone to falls
___ 2. Difficulty with fine hand movements (such as buttoning clothes)
___ 3. Slow or clumsy movements
___ 4. Difficulty initiating or completing movements
___ 5. Daily activities require more physical assistance

Score: Section E total ____points (1 point for each selected item)

F. Temporal Continuity and Self-Perception (Time Sense and Self-Awareness Assessment)​

___ 1. Confuses past and present events
___ 2. Cannot describe the continuity of personal life history
___ 3. Self-identity cognition changes frequently
___ 4. Difficulty understanding the sequential order of events
___ 5. Responds with confusion to the question "Who am I?"

Score: Section F total ____points (1 point for each selected item)

G. System Integration Assessment (Overall Function Coordination Assessment)​

___ 1. Emotional changes obviously affect thinking ability
___ 2. Cognitive ability significantly declines during physical discomfort
___ 3. Environmental changes cause significant functional fluctuations
___ 4. Can be awakened to memories by familiar music or photos
___ 5. Social interaction obviously improves or worsens other functions

Score: Section G total ____points (1 point for each selected item)

H. Logical Association Assessment (Logical Association Capability Assessment)​

___ 1. Cannot connect related events together
___ 2. Difficulty understanding cause-and-effect relationships between things
___ 3. Shows extremely different abilities in different contexts
___ 4. Cannot connect new experiences with past experiences
___ 5. Cannot identify familiar objects in unfamiliar environments

Score: Section H total ____points (1 point for each selected item)

Scoring Results Analysis​

Calculate scores for each section and identify the 2-3 sections with the highest scores:

  • Primary functional impairment type 1: __________ (Score:____)
  • Primary functional impairment type 2: __________ (Score:____)
  • Primary functional impairment type 3: __________ (Score:____)

Home Intervention Recommendations Reference Table​

A. Language and Self-Expression Difficulties (Language Expression Function Impairment)​

  1. Simplify Communication: Use short, clear sentences, express one concept at a time
  2. Picture Communication Board: Create daily needs picture cards to help express basic needs
  3. Daily Reading: Read newspapers or familiar stories to the patient, invite participation
  4. Personal Story Retelling: Frequently discuss the patient's life stories to strengthen self-identity
  5. Writing Practice: Assist in recording simple diary or feelings (if possible)

B. Thinking and Problem-Solving Difficulties (Cognitive Executive Function Impairment)​

  1. Step Cards: Break down complex activities into card steps, complete one step at a time
  2. Classification Games: Classify daily objects and photos, from simple to complex
  3. Simple Puzzles or Logic Toys: Choose difficulty appropriate to ability level
  4. Regular Schedule: Post in prominent places to make life predictable
  5. Maintain Consistent Living Environment: Reduce changes, maintain familiar layout

C. Memory Retrieval and Contextual Association Difficulties (Memory and Contextual Understanding Impairment)​

  1. Memory Cues: Place reminder objects in the environment (such as toilet signs on bathroom doors)
  2. Nostalgic Activities: Regularly look at old photos, listen to old songs, talk about past experiences
  3. Object Purpose Practice: Show daily objects and ask the patient to explain or demonstrate their use
  4. Repetitive Association Practice: Repeatedly connect objects with their usage scenarios
  5. Home Object Labels: Put names and simple explanations on important objects

D. Emotional Response and Social Difficulties (Emotional and Social Function Impairment)​

  1. Music Therapy: Play the patient's favorite music for 15-30 minutes daily
  2. Emotion Cards: Use expression cards to help express current feelings
  3. Touch Comfort: Gentle hand massage or light back patting
  4. Pet Interaction: If possible, arrange pet or stuffed animal companionship
  5. Create Emotion Journal: Record the patient's emotional changes and possible triggers

E. Motor Coordination and Execution Difficulties (Motor Coordination Capability Impairment)​

  1. Simple Exercise: Stretching exercises that can be done while seated, 1-2 times daily
  2. Handicraft Activities: Kneading clay, origami, arranging objects, etc.
  3. Safe Environment Adjustment: Remove obstacles, install handrails, non-slip mats
  4. Rhythm Practice: Clap hands or tap feet to music to strengthen coordination
  5. Use Assistive Devices: Modified utensils, dressing aids, anti-slip equipment

F. Temporal Continuity and Self-Perception Problems (Time Sense and Self-Awareness Impairment)​

  1. Life History Wall: Create photo timeline displaying key life events
  2. Daily Orientation Practice: Gently remind of date, season, and upcoming events
  3. Memory Recording: Record the patient talking about life stories, play regularly
  4. Identity Confirmation Practice: Use mirrors, gentle dialogue to confirm self-identity
  5. Life Ritualization: Establish strong daily ritual sense to strengthen time awareness

G. System Integration Problems (Overall Function Coordination Impairment)​

  1. Comfort Environment Priority: Ensure basic comfort before engaging in cognitive activities
  2. Multi-Sensory Stimulation: Combine visual, auditory, tactile and other multi-sensory integrated activities
  3. Progressive Activities: From simple to complex, observe signs of fatigue
  4. Combine Social and Cognitive: Conduct cognitive practice in social contexts
  5. Environmental Consistency: Reduce frequency of environment changes, establish stability

H. Logical Association Difficulties (Logical Association Capability Impairment)​

  1. Story Continuity Practice: Tell stories and ask the patient to predict outcomes
  2. Daily Object Association Practice: Practice connecting related objects (such as toothbrush-toothpaste)
  3. Contextual Memory Cards: Create context cards, practice identifying appropriate behaviors
  4. Cause-and-Effect Games: Simple "if...then..." exercises
  5. New Uses for Familiar Objects: Explore multiple uses of objects to strengthen associations

Home Context Testing (Supplementary Assessment)​

The following simple tests can help gain deeper understanding of the patient's condition:

  1. Photo Recognition Test:

    • Prepare 3-5 photos of the patient from their younger years
    • Ask "Who is this? What happened?"
    • Observe recognition ability, emotional response, and narrative ability

  2. Simple Sequential Task:

    • Ask the patient to complete a simple sequential task like "making tea"
    • Observe whether they can complete in correct order, how many prompts needed

  3. Music Memory Test:

    • Play songs the patient loved when younger
    • Observe emotional response, memory awakening situation, and related narratives

Implementation Recommendations​

  1. Mixed Intervention: If multiple areas have similar scores, combine different approaches
  2. Gradual Progress: Introduce only 1-2 new activities at a time to avoid overstimulation
  3. Observe and Record: Simply record patient responses to find the most effective methods
  4. Adjust Expectations: Focus on small improvements, accept fluctuations between progress and setbacks
  5. Caregiver Self-Care: Arranging your own rest time is equally important
  6. Flexible Adaptation: Adjust activities according to the patient's daily condition
  7. Regular Re-evaluation: Re-assess every 2-4 weeks, adjust intervention plans

Important Notes​

  • This scale cannot replace professional diagnosis; seek medical assistance for emergencies
  • Patient comfort is always the primary consideration; there's no need to force completion of activities
  • Patience and love are the most important intervention elements
  • The physical and mental health of caregivers is equally important; seek support when needed

This scale has been developed based on advanced cognitive science theories and clinical data mapping, now adjusted as an integrated cognitive function assessment framework, for home-based auxiliary assessment and intervention reference only, not for diagnostic purposes.

Version: 1.0 | Date: May 21, 2025