Observed affect and quality of life in dementia: Further affirmations and problems

This article discusses the ongoing attempt to develop a rating of observed emotion in persons with dementia. The comprehension of the emotional signals of the person with dementia has significant implication for caregiving. The purpose of the present report was twofold: first, to explore training and utilization of the Apparent Affect Rating Scale (AARS) by certified nursing assistants (CNAs) rather than trained research personnel; and second, to test whether the scale showed intraindividual variations in people's affective responses as they moved from one environmental context to another. Results also suggested that the instrument does possess sufficient sensitivity to the behavioral context. Clinical implications for the utilization of the instrument are discussed. CNAs' reliability was less than desirable, suggesting the need for more investment in training, repeated practice, and a commitment to quality improvement.