Functional

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Minimizing Disability Associated with Alzheimer
Disease The Functional Transitions Model Susan
Slaughter, RN, MSc(A), Jane Bankes, RN, MN,
Neil Drummond, PhD
Department of Family Medicine Department of
Community Health Sciences Calgary Health Region
Practice Implications - Families are often
hope for the best but are not aware of what
transitions lie ahead. - Health providers often
expect progressive functional decline but do not
always recognize excess disability. - The paradox
of hoping for the best while preparing for the
worst is challenging for both families and care
providers.
Origin of the Functional Transitions Model
(FTM) Clinical practice in long-term care
settings led to the development of the FTM which
integrates three constructs 1. Progressive
cognitive physical functional decline
associated with Alzheimer disease (AD) 2.
Reversible functional decline, in excess of that
associated with AD. Excess disability may be
attributed to co-morbidities, adverse drug
effects, sensory deficits, psychological factors,
elements of the social or physical environment ,
symptoms such as pain or constipation. 3.
Transition is a passage from one state, stage or
place to another which involves a three phase
adjustment process in response to change.
Functional Transitions Model
Functional Abilities
Education Implications - Targeting families and
health providers could address this clinical
paradox. - The FTM has been successfully
integrated into a dementia curriculum in a
long-term care environment where gt 70 of
residents have some degree of dementia
Research Implications - Attribution theory
could guide research into family and staff
attributions of functional transitions. -
Prospective longitudinal study of people with
early stage dementia and their caregivers to
identify their understanding of, and response to,
functional transitions - Evaluation of
educational interventions to address the clinical
paradox described above
Time
Transition Trajectories in AD - recognizing a
problem - getting a diagnosis - needing
psychosocial support - needing IADL support -
needing basic ADL support (bathing, dressing,
toileting, mobility, eating)
This research is supported by Alberta Heritage
Foundation for Medical Research and Canadian
Institutes of Health Research (CIHR)
http//www.ucalgary.ca/dementianet/