Electronic Dementia Guide for Excellence (EDGE) Project

The EDGE Project was developed with funding from the New York State Department of Health, Office of Continuing Care. (PDF, 3.28MB, 11pg.) EDGE has evolved through many phases since its inception in 1995.

EDGE is a web based resource program. Using the Internet as a mode of access and distribution, EDGE works by giving staff members in dementia care settings the tools they need to help them provide quality care. The program offers guidance to identify and implement interventions that specifically address care and communication challenges faced in dementia care.

Why Use the EDGE Program?

The primary goal of the EDGE project is to develop and disseminate a computerized system of information to promote quality care of residents with dementia in nursing facilities.

EDGE is designed to:

  1. have practical use in the long term care setting;
  2. be extremely user-friendly;
  3. be a real help to improve quality of life for persons with dementia in nursing facilities;
  4. reflect research based state of the art techniques and care practices;
  5. delineate best living practices without being prescriptive;
  6. cover the most relevant subject areas within a reasonable scope of information; and,
  7. provide interventions/approaches for residents throughout the functional phases in Alzheimer's Disease and related dementias.

It is essentially a quality improvement tool that:

  1. Seeks to improve the process of caring for residents with dementia in long term care by teaching all persons who deal with the resident how to support the resident's attempts to obtain the highest quality of life possible.
  2. Includes receiving input for the care plan from all persons who have an impact on the resident's life:
    1. staff in all departments
    2. family
    3. volunteers
    4. frequent visitors
  3. Provides a means to help all staff in the facility understand the needs of a resident trying to cope with the challenges of living with dementia.
  4. Looks at a resident with dementia as a person with a memory impairment who needs certain adaptive requirements to function at his/her highest level, just as any other person who is mentally or physically challenged does.
  5. Does not consider these adaptations "special care", but necessary care; as wheelchairs, walkers, and hearing aids are for persons who need them to cope with certain physical challenges.
  6. Is meant to be a starting point to help all facility staff to learn how to assess the ongoing needs of their residents with dementia in a comprehensive way in order to plan interventions and services that meet their needs.
  7. Is based on the BASICS Hierarchy of Resident Needs in long term care which outlines the needs of a resident with dementia on every level, from most basic-biological (life-sustaining) to the highest level-creative and symbolic (life-defining), the same needs we all have.
  8. Uses BASICS to look at a resident's problems and strengths to present a comprehensive picture of how well the resident's needs on every level are being met in the facility. BASICS gives staff a place to start in planning care for residents with multiple problems.
  9. Provides inservices and worksheets to teach staff to evaluate each resident with dementia in order to determine his/her place on the BASICS Hierarchy and then to plan interventions to satisfy needs on that level. In this way, the resident is supported to reach for the next level of need satisfaction.
  10. Illuminate the fact that, conversely, when a level of need is not satisfied (such as the need for self-dependence, sometimes not fostered because of institutional rituals), a resident can remain stuck on one level and as a result behave in a distressed or distressing way. The resident may even regress to a lower level of function when strengths are not recognized and supported.
  11. Is based on the research indicating that problem behavior is often caused by unmet needs. The program uses EDGE Caregiver Goals to direct quality care by focusing staff on what they can do to meet resident needs on every level of BASICS proposing that "problem behavior" is caused by unmet needs. Specific examples of how to meet each of the six Caregiver Goals during daily care are provided.
  12. EDGE looks at a person with dementia as a whole person with multiple needs and many personal resources instead of as a one-dimensional confused person with a particular memory-based problem that needs to be addressed.

Residents with dementia are often thought of, and care planned for, as "persons with wandering problems" or "persons with disruptive behaviors." The Residents' other needs and strengths may not be considered when planning more comprehensive methods of helping them meet their needs and achieve successful adaptation to life within the facility.

EDGE provides interventions composed of the following sections:

  • What is it? (Purpose)
  • Goals and Benefits
  • Program Structure (Duration, staff and equipment needed, participant selection)
  • Inservice (For staff)
  • Ritual (Program format)
  • Troubleshooting (Problems & solutions)
  • Outcomes (Program results)
  • References (For EDGE content)
  • Forms (Available in PDF)

The interventions put current and credible resources in dementia care, complete with an implementation plan to use them, right into the facility, where they are accessible to all staff.

The guidelines for each intervention in the EDGE program start with an evaluation of the resident's needs in reference to the particular problem it addresses. They also include definitions and criteria to use in assessing problems to clarify and standardize the meaning of terms used in the assessment.

The EDGE format can be used to implement any intervention that might be beneficial to a resident. It is a teaching tool that guides staff in every department to use it to become competent in meeting the needs of the residents with dementia they serve. While EDGE's primary focus is on long term care settings including nursing homes and adult care facilities, it can be used in other settings such as adult day programs.

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