The Environment and Communication Assessment Toolkit for Dementia Care (ECAT)
The Environment and Communication Assessment Toolkit for Dementia Care
As communication skills decline in people with dementia, a supportive environment becomes crucial to a resident’s ability to express needs and desires. This evidence-based toolkit will help you recognize what physical and social changes will improve functioning and communication.
Environment & Communication Assessment Toolkit (ECAT) for Dementia Care (with meters)
By Jennifer Brush, M.A., CCC-SLP, Margaret Calkins, PhD, CAPS, EDAC, Carrie Bruce, MA, CCC-SLP, ATP, and Jon Sanford, M.Arch
ECAT for Dementia Care has more than 300 specific recommendations for interventions and modifications that will reduce typical problems encountered during routine activities of daily living for people with dementia. With the ECAT’s functionally based assessment and intervention system, you’re equipped with solutions!
Add to cart
What's in the Kit
What You Get in the Boxed Set
- ECAT Manual*
- ECAT Assessment Forms*
- ECAT Cue Card Pack*
- CD-ROM (of reproducible forms and cards)
- Light and sound meters
*Also sold separately (see below)
ECAT at a Glance
Proven Assessment to Improve Quality of Life
Where to use: Personal and public spaces in long-term care settings, assisted living, skilled nursing, memory care, and home settings
What is assessed: Visibility, wayfinding and navigation, contrast, sound and high levels, room signage, time/location cues, public restroom, dining room, leisure and social activity areas, and the social environment
Who completes the ECAT: SLPs, OTs, PTs, nurses, social workers, case managers, therapeutic recreation professionals, other dementia care professionals
Time required: 30-60 minutes
Training required: None
Evidence base: Tested across a 3-year development period funded by NIDCD with strong effectiveness outcomes across four measures (clinical knowledge, impact on practice, utility of information, and usability of material)
ECAT developers/advisors: SLPs and architects who specialize in dementia care; an expert technical advisory committee from speech-language pathology, occupational therapy, physical therapy, nursing, and gerontology; clinical review panel of rehabilitation, nursing, and activity professionals working in long-term care communities
How ECAT Works
Assess, Intervene, Modify
The ECAT Manual
The starting point for using the Environment and Communication Assessment Toolkit, the ECAT Manual is a user’s guide, technical manual, and educational resource.
- Details how the environment impacts various aspects of communication for a client with dementia
- Describes step-by-step how to complete the assessments
- Includes appropriate interventions and modifications in handy tables cross-referenced to the assessments
- Includes everything you need to know about lighting (methods, types, fixtures, bulbs, suppliers, and more)
ECAT Assessment Forms
The ECAT Assessment Forms quickly identify environmental barriers that are preventing your residents from participating in activities of daily living, leisure activities, or social communication in both public spaces and their own personal space.
With simple yes/no questions, these forms let you organize, analyze, and translate assessment results into appropriate recommendations for intervention. Each form has three sections: Activity Performance, Environmental Measures, and Recommendations for Intervention.
- 6-page Evaluation of Personal Spaces Assessment Form
- 5-page Evaluation of Public Spaces Assessment Form
ECAT Cue Cards
25-card pack includes
- 24 full-color sequencing cue cards
- 1 double-sided, one-color, 8.5 x 11 card (Gray Scale Contrast Tool & Type Size Reading Test)
The ECAT Sequencing Cue Cards are color illustrations of common sequences of activities of daily living, including getting dressed, taking a shower, using the toilet, and washing one’s face. The cue cards are supplied as durable, reusable cards.
- ECAT Personal Space Signs: Full-page color drawings of Toilet, Bathroom, and Closet
- Gray Scale Contrast Tool: Card to determine whether signage in a person’s environment has adequate contrast
- Type Size Reading Test: A one-page test to ensure that signage is the right size for the person’s needs
Sound and Light Meters, and ECAT CD-ROM
The toolkit also includes sound and light meters to assist you in measuring the environment, as well as a CD-ROM with reproducible forms and cards.
ECAT Products
“[Here are] the long overdue tools needed by speech-language pathologists to determine the appropriate environmental cues for their clients with dementia to maintain a quality life in the nursing home. Thank you for this excellent resource.”
—Michelle Bourgeois, PhD, Professor, Department of Speech and Hearing Science, The Ohio State University
Results of the ECAT Study
Proven and Evidence-Based
To evaluate the effectiveness of the materials, ECAT was implemented by a diverse group of 63 speech-language pathologists, occupational therapists, physical therapists, and nurses who used the toolkit with their clients for 6 months. The effectiveness of ECAT was measured by four factors:
Awareness: The increase in awareness of environmental modifications prior to and after ECAT training was highly significant.
Impact: After using ECAT for just five months, the majority of clinicians used 80% of the modifications, and more than half of the clinicians continued to use ECAT on their own as part of their clinical practice after they met the requirements of the study.
Utility: 9 out of 10 clinicians agreed or strongly agreed that ECAT for Dementia Care had useful information, added value to their clinical practice, and benefited their clients.
Usability: Over 90% of clinicians agreed or strongly agreed that the information was easy to understand and that the ECAT was easy to use.
Download a paper showing case studies of the use of ECAT in various settings.
Praise for ECAT
What Users Are Saying!
“In one woman’s bathroom, we added contrasting colors … Prior to this $10 modification of buying new towels and using blue paper, she would use her hand towel for toileting hygiene AND wiping her hands and face. It was a HUGE hygiene issue. Now she demonstrates great hygiene without cuing! SUCCESS!”
“One patient … began struggling more with pathfinding to her apartment … I took her shopping on an activities outing and had her pick out the color of flowers she would like to hang … [Now] she can independently recall what color to look for when asked. It has definitely increased her success with pathfinding, especially since she picked a color that is meaningful to her.”
“A patient was eating in his room, as he was unable to distinguish between jeans and slacks [no jeans are allowed in our dining room]. Re-arranging his closet with sections for day and for evening attire allowed him to dress appropriately and go to the dining room in the evening. It made a positive impact on his psychosocial wellbeing.”
About the Authors
Who Created ECAT
Jennifer Brush, M.A., CCC-SLP: Nationally recognized speech-language pathologist, particularly in the areas of memory and swallowing interventions for people with dementia. She is also the author of numerous books.
Margaret P. Calkins, Ph.D., CAPS, EDAC: Widely recognized as an expert in the creation and evaluation of long-term care settings, particularly for people with dementia. She is also widely published in both academic and trade journals.
Carrie Bruce, M.A., CCC-SLP, ATP: Licensed speech-language pathologist and assistive technology practitioner.
Jon Sanford, M.Arch: Associate Professor in the College of Architecture at Georgia Tech and the Director of the Center for Assistive Technology and Environmental Access (CATEA).
“This toolkit is a must have, foundational resource for personalizing the environment while cultivating the possibilities that exist for human growth and meaningful relationships in dementia care settings.”
—Heidi Gil, Senior Director of Continuing Care, Planetree
Look Inside ECAT!
ECAT Excerpts from The HPP Blog
8 Tips for Communicating with Clients Who Have Hearing Loss
Hearing is one of the first senses affected by the aging processes, and often makes communication more difficult, causing older adults to withdraw socially. These disruptions of daily life may seem small or insignificant to a person with intact hearing, but for a person who is hard of hearing or deaf, difficult listening situations are a way of life, all day long, every day. Here are some tips to help you communicate with someone with hearing loss or language comprehension problems.
Read blog post
Environmental Interventions to Ensure Resident Safety in Bathrooms
Lighting, contrast, and signage are all ways to improve a resident’s bathroom to ensure it is as safe as possible. Download this handy infographic for a quick look at these three ways you can put safety (and the person!) first in bathrooms.
Read blog post
Implementing Modifications in the Care Community
Environmental interventions and modifications may require approval and/or funding to implement. When requesting funding from a supervisor or the administrator of your care community, here are a few things to keep in mind.
Read the blog post