Assessment of dementia in nursing home residents by nurses and assistants: criteria validity and determinants

Objectives To describe the criterion validity of nursing home staff's assessment of organic disorder compared with ICD‐10 criteria, and to identify determinants of staff assessment of organic disorder. Method Two hundred and eighty‐eight residents were diagnosed using the GMS‐AGECAT. Nursing staff members were interviewed about the residents' activities of Daily Living, behavioural problems, orientation in surroundings and communication skills, and asked if the resident had an organic disorder. Multiple logistic regression was used to select the items that most strongly determined staff assessment of organic disorder. Results Sixty‐two per cent of the residents were diagnosed by GMS‐AGECAT as having organic disorder, 78% of these were correctly identified by the staff. Whether analysed among residents with or without organic disorder, or in the total group of residents, the staff assessment of the presence of organic disorder depended on a limited set of behavioural characteristics of the resident, namely ‘going to the toilet in inappropriate places’, ‘saying things that do not make sense’ and impairment in orientation. Conclusions Staff comprehension of organic disorder resulted in over‐ as well as under‐labelling of residents, a tendency that will affect communication with medical personnel and may lead to inadequate or wrong medical treatment and to negative performance as well as negative role expectations in everyday life in nursing homes. Copyright © 2001 John Wiley & Sons, Ltd.