PANSiS

The Positive and Negative Signs Scale is a new instrument for measuring wellbeing in people who have dementia and may be unable to communicate their subjective wellbeing verbally. It lists 19 positive and 19 negative behavioural indicators of wellbeing and illbeing.

The PANSiS is important because it gives staff a tool they can use  to record and measure indicators of wellbeing or illbeing. It can be used regularly as a measure of how well the care plan is being implemented, at Resident of the Day care plan reviews. If for example staff  do not see any signs of wellbeing from the recipient of sexual advances they should act to preserve the person’s wellbeing by removing them or distracting the initiator away.

The PANSiS is also helpful in giving specific indicators of “willingness to participate” which is effectively consent. I emphasise that it is a “sensory emotional” consent and not a higher order medico-legal consent that the person with dementia may be giving. This is essentially a consent the person gives when what they are doing feels good  in some way and feels right for them to be involved in. They show this through their behavioural signs. If there are no signs of wellbeing and only signs of illbeing, especially passive signs, the interaction should be interrupted.

Staff should also monitor for signs of wellbeing regularly if they believe a person with dementia is interacting socially with another person and they think it may involve some activity that could result in a risk to emotional wellbeing. The PANSIS is the instrument they can use to regularly and quickly note what signs they are seeing. This can be as frequently as half-hourly and can be similar to a “Whereabouts chart”.