Observational assessment of communication to empower patients with dementia to make legally effective decisions – revalidation of CODEM_amb

Abstract

Objectives: Communication enables humans to exercise their rights. Dementia research consistently shows that communication skills decrease as the disease progresses. Nonverbal communication abilities decline more slowly than verbal skills and often become more important as the disease advances. However, resources and deficits in nonverbal and verbal communication behavior differ between persons with dementia and contexts. Knebel et al. proposed the observational assessment tool CODEM_amb that we believe to be the first standardized instrument to differentiate between content-related and relationship aspects of nonverbal communication behavior. Until now, evaluations of CODEM_amb have been exploratory and used small samples.

Method: We therefore retested the psychometric criteria of CODEM_amb in persons with a suspected dementia in an ambulatory setting. Data was drawn from 326 older adults (aged 52 − 91) during routine screening in Germany.

Results: Our findings support the three-factorial structure of CODEM_amb. Internal consistency of the overall scale and the three subscales of CODEM_amb was high. Correlations with CERAD-NP subscales revealed similarities to CODEM_amb, indicating sufficient convergent validity. Finally, CODEM_amb was able to differentiate between persons according to the stage of their disease.

Conclusion: CODEM_amb is a theoretically based, reliable and valid observational assessment tool and its use in ambulatory settings can help foster individual, person-centered communication by identifying the resources of people with dementia, thereby empowering them in rights-exercising situations.

Keywords:

• Dementia
• communication
• assessment
• supported
• decision
• making

Acknowledgments

The authors are grateful to Phillip Elliot and Christopher Strahlenbach for editing the manuscript. We thank those that made this study possible.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was funded by the Volkswagen Stiftung under Grant number 85213.