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PIECE-dem

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PIECE-dem: an observational framework focussing on the perspective of residents with advanced dementia.

PIECE-dem was developed by ADS as part of the PANIOCA (Prevention of Abuse and Neglect in the Institutional Care of Older Adults) programme. PANICOA is a joint-funded research initiative between the Department of Health and Comic Relief which is designed to enhance the dignity of older people in institutional settings. It focuses on supporting research that addresses the issue of abuse, neglect and loss of dignity in care for older people. There has been a lot of media coverage about the poor quality of care but little thorough, large-scale research to assess the extent and nature of the problem.

PIECE-dem is an observational process that illuminates the experience of those people with advanced dementia and high levels of need, who are most vulnerable in long-term care settings. PIECE-dem is an acronym for:


For a brief overview of the PIECE-dem process, please see our flyer. The final report on the development of PIECE-dem is also available. This report includes an instruction manual for using PIECE-dem.

PIECE-dem was used in the final PANICOA project, CHOICE (Care Home Organisations Implementing Cultures of Excellence). ADS is developing PIECE-dem further so that it can be used by practitioners to assist them in assessing the experience of their most vulnerable residents. This will take the form of an instruction manual and accompanying training course. If you would like to register your interest, please use this form.