P2‐486: DEVELOPMENT AND VALIDATION OF A WANDER‐MANAGEMENT GUIDELINE FOR PERSONS WITH DEMENTIA AT RISK OF GETTING LOST
Bibliographic record
Abstract
Three in five persons with dementia will wander and become lost raising concern as to how it can be managed effectively. No guideline exists to help people select and adopt strategies for management of risks of getting lost in persons with dementia. The purpose of this study was to develop and validate a guideline that will help stakeholders choose strategies to manage challenging behaviours associated with dementia-related wandering. Semi-structured individual phone interviews containing 12 questions were conducted with family and formal caregivers, persons with mild dementia, health practitioners, police, social workers, industry and staff from community organizations that work with people affected by dementia. The purpose of the interviews was to determine what factors influenced strategy adoption of wander-management strategies and to identify differences between stakeholders. A secondary study involving family and formal caregivers identified antecedent behaviours indicative of critical wandering. Participants were requested to record daily observations of these behaviours among the persons with dementia within their care for 4 weeks. Responses from these interviews and observations were used to develop a guideline for strategy adoption of wander-management strategies. Face validity of the guideline was then assessed through 11 focus groups across stakeholders. A total of 41 participants participated in the development of the guideline, and 34 participants assessed its face validity. Responses from the interviews produced 4 contextual factors that influence the successful adoption of wander-management strategies: (1) Risk associated with wandering; (2) Culture; (3) Geography; (4) Stigma. Perceived risk was conveyed as the most influential factor of strategy adoption across all stakeholder groups. Common antecedent behaviours of critical wandering events ranged from packing of belongings, preparing to go outside, and door lingering or tampering within continuing care facilities. The relationships of these 4 factors and antecedent behaviours were incorporated in the guideline. This is the first study to describe and validate factors that influence strategy adoption for dementia-related wandering. The guideline of strategies will be made available for use by caregivers, health and community service providers to identify strategies to mitigate the risks associated with critical wandering.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.036 | 0.081 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".