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BioMed Research International
Volume 2015, Article ID 749451, 8 pages
Research Article

Deep Assessment: A Novel Framework for Improving the Care of People with Very Advanced Alzheimer’s Disease

1Centre for Special Education and Disability Studies, University of Newcastle, Callaghan, NSW 2308, Australia
2School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia

Received 21 August 2015; Revised 2 November 2015; Accepted 2 November 2015

Academic Editor: Grazia D’Onofrio

Copyright © 2015 Gordon Lyons et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Best practice in understanding and caring for people with advanced Alzheimer’s disease presents extraordinary challenges. Their severe and deteriorating cognitive impairments are such that carers find progressive difficulty in authentically ascertaining and responding to interests, preferences, and needs. Deep assessment, a novel multifaceted framework drawn from research into the experiences of others with severe cognitive impairments, has potential to empower carers and other support professionals to develop an enhanced understanding of people with advanced Alzheimer’s disease and so deliver better calibrated care in attempts to maximize quality of life. Deep assessment uses a combination of techniques, namely, Behaviour State Observation, Triangulated Proxy Reporting, and Startle Reflex Modulation Measurement, to deliver a comprehensive and deep assessment of the inner states (awareness, preferences, likes, and dislikes) of people who cannot reliably self-report. This paper explains deep assessment and its current applications. It then suggests how it can be applied to people with advanced Alzheimer’s disease to develop others’ understanding of their inner states and to help improve their quality of life. An illustrative hypothetical vignette is used to amplify this framework. We discuss the potential utility and efficacy of this technique for this population and we also propose other human conditions that may benefit from research using a deep assessment approach.