The BEAT-SA™ (Brief Engagement and Attention Tool for Situational Awareness) is an instrument developed by the BCAT® Research Center to measure situational awareness, particularly for people with dementia; and to improve prediction of behavioral and psychological symptoms of dementia (BPSD), resistance to care, and attentional skills for participating in life enrichment activities.

Situational awareness refers to a person’s perceptual recognition and cognitive understanding of an immediate environmental context (e.g., bathing, toileting, dressing, participating in a life enrichment activity). It also includes the necessary skills to appropriately respond to the current situation. In dementia, situational awareness typically declines with losses in cognitive functioning. Poor situational awareness is associated with BPSD, poor engagement in care, and suboptimal participation in social activities.

From a care perspective, rapidly assessing attention and engagement are key to improving care for those with dementia. They are also essential cognitive components to functional performance. The BEAT-SA™ can be administered by caregivers and healthcare professionals. It has companion interpretative crosswalk tables to assist in care planning.

• Strong reliability (inter-rater reliability).

• Strong construct validity (convergent and discriminant).

• Strong predictive validity (for BPSDs).

• The normative and development study participants were aged 50+ residing in senior living communities and skilled nursing homes.

• Three clinical score ranges with statistically significant predictive values.

• Study analyses support a total test score plus 4 subtest scores (orientation, command processing, verbal engagement, visual attention).

• No education, race, or age biases found.

• Associated score-specific caregiver strategies for reducing dementia-related behaviors during care.

To determine cognitive level, first administer the BCAT®, BCAT®-SF, or BCIS®. The BEAT-SA™ is recommended when the BCAT® score is under 25, the BCAT®-SF score is under 13, or the BCIS® score is under 13.  However, the BEAT-SA™ can also be used on its own.

To complete the BEAT-SA™:

1. Administer each BEAT-SA™ subtest and obtain each subtest score.
2. Add all subtest scores to obtain a BEAT-SA™ Total Score.
3. Refer to Table ‘A’ for the Situational Awareness (SA) level and corresponding considerations based on the BEAT-SA™ Total Score.
4. Refer to Table ‘B’ for actionable takeaways based on the individual subtest scores (i.e., orientation, command processing, verbal engagement, visual attention). Share key considerations with the interprofessional team to inform resident specific care planning.
5. Review the Common BEAT-SA™ Subtest Pathways in Dementia care which provide two profiles that inform care around dementia related behaviors, resistance to care, and falls.

The BEAT-SA™ can be repeated as often as necessary.

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