Lesson 1Mobility, falls risk and gait: Timed Up and Go, Morse Fall Scale, orthostatic vitalsAddresses mobility, gait, and falls risk assessment in dementia using Timed Up and Go, Morse Fall Scale, and orthostatic vitals. Emphasizes multifactorial risk analysis and targeted prevention strategies to maintain safe mobility in everyday settings.
Taking a focused mobility and falls historyPerforming the Timed Up and Go test safelyUsing the Morse Fall Scale and interpreting scoresMeasuring orthostatic vitals and dizziness symptomsDesigning individualized falls prevention plansLesson 2Nutrition and hydration evaluation: weight trends, meal intake records, swallowing screening, MNA (Mini Nutritional Assessment)Details comprehensive assessment of nutrition and hydration in dementia, including weight trends, intake records, swallowing screening, and MNA. Emphasizes early risk detection, aspiration prevention, and individualized care strategies adapted to local diets.
Reviewing weight history and BMI trends over timeMonitoring meal intake, snacks, and fluid balanceScreening swallowing and aspiration risk at bedsideAdministering and interpreting the MNA toolPlanning interventions for malnutrition and dehydrationLesson 3Pain assessment in cognitively impaired patients: PAINAD, Abbey Pain Scale, observational indicatorsProvides a framework for assessing pain in people with cognitive impairment using PAINAD, Abbey Pain Scale, and behavioral cues. Emphasizes baseline behaviors, cultural factors common in Kenya, and evaluating response to analgesic interventions.
Recognizing atypical and behavioral pain indicatorsUsing the PAINAD scale step by stepApplying the Abbey Pain Scale in practiceDifferentiating pain from agitation or deliriumReassessing pain after interventions and documentingLesson 4Sleep and nighttime behavior assessment: sleep-wake patterns, sleep diaries, sleep disturbance scalesFocuses on evaluating sleep and nighttime behaviours in dementia, using sleep diaries, caregiver reports, and standardized scales. Addresses circadian disruption, safety risks, and nonpharmacologic strategies to improve sleep quality in home or facility care.
Collecting sleep-wake history and bedtime routinesUsing sleep diaries and actigraphy when availableApplying sleep disturbance scales in dementiaIdentifying nocturnal wandering and safety risksNonpharmacologic strategies to improve sleepLesson 5Behavioral symptom mapping: ABC (Antecedent-Behavior-Consequence) charting and frequency/severity logsCovers structured mapping of behavioral and psychological symptoms using ABC charts and severity logs. Teaches pattern recognition, linking triggers to behaviours, and using data to guide nonpharmacologic interventions and team planning in Kenyan contexts.
Principles of ABC (Antecedent-Behavior-Consequence)Designing clear behavior definitions and rating scalesCompleting ABC charts in real time on the unitAnalyzing frequency, severity, and temporal patternsUsing mapping data to tailor interventions and careLesson 6Continence and toileting patterns: bladder/bowel charting and prompted voiding assessmentCovers systematic assessment of continence and toileting in dementia, including bladder and bowel charting, patterns, and prompted voiding trials. Highlights skin protection, dignity, and reversible causes of incontinence relevant to local practices.
Collecting continence history and current routinesUsing bladder and bowel charts for pattern trackingAssessing for reversible causes of incontinenceImplementing prompted voiding and timed toiletingProtecting skin and preserving privacy and dignityLesson 7Environment and psychosocial factors: room setup, triggers, social engagement, family dynamicsExamines how physical environment and psychosocial context influence function and distress in dementia. Focuses on room layout, sensory load, routines, social engagement, and family dynamics to reduce triggers and support well-being in community settings.
Assessing room layout, lighting, and noise levelsIdentifying environmental triggers and overstimulationEvaluating routines, structure, and meaningful activityAssessing social engagement and isolation riskExploring family roles, conflict, and caregiver stressLesson 8Cognition and mood screening: MMSE, MoCA, Global Deterioration Scale, Cornell Scale for Depression in DementiaExplores structured screening of cognition and mood in dementia using MMSE, MoCA, GDS, and Cornell Scale. Emphasizes baseline comparison, cultural factors in Kenya, and integrating findings into care planning and communication.
Selecting appropriate cognitive screening toolsAdministering MMSE and MoCA reliablyUsing the Global Deterioration Scale for stagingScreening depression with the Cornell ScaleCommunicating results to team, patient, and familyLesson 9Skin and wound assessment: pressure risk scales (Braden), documentation of skin tears and sacral rednessDetails comprehensive skin and wound assessment in dementia, including Braden scoring, early pressure injury signs, and documentation of tears and redness. Emphasizes prevention, repositioning, and interdisciplinary follow-up in resource-limited settings.
Performing a head-to-toe skin inspectionUsing the Braden Scale and interpreting risk levelsIdentifying early pressure injury and sacral rednessAssessing and documenting skin tears accuratelyPlanning prevention, dressings, and follow-up careLesson 10Collecting immediate 24-hour history: vital signs, recent changes, baseline function, and ADLsGuides nurses in collecting a focused 24-hour history, including vital signs, recent changes, baseline function, and ADLs. Supports rapid detection of acute illness, delirium, or decline and informs immediate care priorities in busy wards.
Reviewing recent vital signs and pain scoresIdentifying new symptoms and behavior changesClarifying baseline cognition and functional statusDocumenting ADL performance and support needsPrioritizing urgent concerns for provider reviewLesson 11Medication review and polypharmacy check: anticholinergics, sedatives, hypoglycemics, antihypertensives, recent changes and PRN useExplores systematic medication reconciliation for people with dementia, focusing on high-risk drugs, PRN use, and recent changes. Emphasizes detecting adverse effects, deprescribing opportunities, and collaborating with prescribers in Kenyan healthcare.
Collecting complete medication and allergy historiesIdentifying high-risk anticholinergic and sedative drugsReviewing hypoglycemics and antihypertensives safelyAssessing PRN use, duplication, and drug interactionsCommunicating concerns and deprescribing with prescribers
