The development and preliminary testing of the Safe Walking Assessment and Planning (SWAP) tool

Despite the known life threatening outcomes associated with dementia-related wandering (exhaustion, malnutrition/dehydration, getting lost, injury), in clinical practice there are currently no validated tools to assess the risks related to wandering and few evidence-based care planning resources available. The Safe Walking Assessment and Planning (SWAP) tool, a newly developed tool, has the potential to a) identify risks associated with the type and intensity of walking, b) provide care planning advice for each identified risk and c) collect vital personal information about the person with dementia to assist with a search if needed. The SWAP tool items were generated from a review of current research evidence and two consultation rounds with an expert panel (N=11; n=3 family carers, n=3 nurses, n=5 dementia researchers). The original 35 items reviewed in Round 1 were reduced to 13 in Round 2 with consensus the items were relevant and acceptable across all care settings, accurately measured risk associated with wandering, and provided appropriate care planning recommendations. Preliminary testing of the resultant SWAP tool with potential end users (N=5; n=3 nurses; n=2 family carers) demonstrated consensus that the tool is easy to use, applicable to all care settings, and that the care advice provided is useful. Nurse users expressed concern that adding the SWAP tool to their already extensive suite of assessments would create additional burden. The practical application of the tool to guide individual care planning was seen as a positive attribute. Psychometric testing of the modified SWAP tool is now in progress.