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Development and Validation of the End-of-Life Assessment Tool for Advanced Dementia: A Multi Method Study
Carolyn Bourke1, Lynn Chenoweth2, Ekavi Georgousopoulou3,4
1Health/UARC, University of Technology Sydney, Ultimo, New South Wales, Australia.
Journal of Advanced Nursing
|August 6, 2025
Summary
The End-of-Life Care Assessment Tool for Dementia (EoLC-ATD) accurately identifies advanced dementia symptoms. This validated tool helps nurses provide tailored palliative care for individuals with dementia.
Area of Science:
- Gerontology
- Palliative Care
- Dementia Studies
Background:
- Assessing advanced dementia symptoms is crucial for effective palliative care.
- A validated tool is needed for nurses in aged care to identify unique end-of-life needs.
- Current measures may not adequately capture the symptom spectrum in advanced dementia.
Purpose of the Study:
- To develop and validate the End-of-Life Care Assessment Tool for Dementia (EoLC-ATD).
- To create a reliable measure for identifying advanced dementia symptoms.
- To support nurses in recognizing palliative care requirements based on symptoms.
Main Methods:
- A multi-phase methodological study.
- Item bank development from 90 dementia measures.
- Focus groups with nurses, Delphi surveys with experts, and pilot/field testing with persons with dementia.
Main Results:
- The 27-item EoLC-ATD accurately identified advanced dementia symptoms (Cronbach's alpha 77.0).
- The tool demonstrated good inter-rater reliability for constructs and items.
- EoLC-ATD use was significantly associated with mortality within 180 days.
Conclusions:
- The EoLC-ATD is an accurate and reliable measure for advanced dementia symptoms.
- It addresses the need for a validated tool in aged care settings.
- The EoLC-ATD facilitates identification of symptom-responsive palliative care needs.
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