Research Article

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

Table 1

Summary of the three techniques comprising deep assessment.

TechniqueDescriptionAdvantagesKey refs.

Behaviour State ObservationAn observational protocol that uses fine-grained category codes to allow judgements about a person and their social and communicative contexts.A detailed and systematic means of connecting individual levels of alertness and engagement with a range of relevant contextual variables, including sociocommunicative elements.[15, 16]

Triangulated Proxy ReportingA systematic consultative process drawing on the close personal knowledge of individual needs as displayed in a range of natural settings.It allows for the authentic and powerful input of those who know the person best. It allows the direct translation of carer knowledge into planning and support for the person with participation challenges.[17, 18]

Startle Reflex Modulation An electrophysiological measurement of emotion. The amplitude of a person’s reflexive eye blink in response to a startling stimulus indicates whether the individual is experiencing a more unpleasant or a more pleasant inner state.It allows unbiased and implicit measurement, not requiring verbal responses. A reliable indicator of basic emotional preference even for a person in cognitive decline.[19, 20]