Health Quality Ontario’s Dementia Care for People Living in the Community Quality Standard provides guidance for the care of people living with dementia in the community, including the assessment of people suspected to have dementia or mild cognitive impairment. The care settings for this quality standard include primary care, specialist care, hospital outpatient services, home care, and community support services.
The quality standard includes 10 quality statements addressing areas that were identified as having high potential for improving the quality of care in Ontario for people living with dementia in the community.
Below is a sample of tools and resources that may help you with the implementation of the quality statements into practice. Please also see the Dementia Care for People Living in the Community Quality Standard for more tools and information, and its partnering quality standard, Behavioral Symptoms of Dementia.
Are there other tools or resources you use? Do you have experience implementing these tools? If you have any feedback about any of these tools, please use the comments section below to share!
Tools and Resources for Each Quality Statement
Quality Statement 1. Comprehensive Assessment and Diagnosis: People suspected to have mild cognitive impairment or dementia receive a comprehensive assessment when signs are first identified. If diagnosed with either condition, they are then reassessed on a regular basis or when there is a significant change in their condition.
The quality standard lists nine elements that should be included in a comprehensive interprofessional assessment for people with dementia. Please see the Dementia Care for People Living in the Community Quality Standard for more information.
Quality Statement 2. Interprofessional Care Team: People living with dementia have access to community-based dementia care from an interprofessional team with expertise in dementia care, of which the person living with dementia and their caregivers are integral team members.
Quality Statement 3. Individualized Care Plan: People living with dementia have an individualized care plan that guides their care. The plan identifies their individual needs, those of their caregivers, and goals of care. The plan is reviewed and updated on a regular basis, including documentation of changing needs and goals and the person’s response to interventions.
Please also see the Dementia Care for People Living in the Community Quality Standard for a full list of very diverse components (e.g., comprehensive assessment, a plan for physical exercise, a nutrition care plan, environmental modifications) to be considered when developing an individualized care plan.
- P.I.E.C.E.S.—a practical framework for assessment and supportive care strategies using a person-centred approach to support the care of older individuals living with complex chronic disease, including neurocognitive disorders and their associated behavioural changes
- Sleep Issues and Sundowning—information from the Alzheimer’s Association about sleep issues and behavioural problems that begin at dusk and last into the night (known as sundowning)
Quality Statement 4. Named Point of Contact: People living with dementia and their caregivers have one or more named providers on the interprofessional care team who serve as a point of contact to facilitate care coordination and transitions across settings.
There are no specific tools identified for this statement.
Quality Statement 5. Education and Training for People Living With Dementia and Their Caregivers: People living with dementia and their caregivers have access to education and training on dementia and available support services.
- Alzheimer Society of Canada—resources by the Alzheimer Society of Canada for people with dementia, caregivers, and health care professionals
- Baycrest—information and resources in plain language for people with dementia and caregivers
Quality Statement 6. Education and Training for Health Care Providers: Health care providers delivering care and services to people living with dementia receive education and training in dementia care.
Quality Statement 7. Access to Support Services: People living with dementia and their caregivers have access to support services that are individualized and meet their ongoing goals and needs.
- First Link—a program created by the Alzheimer Society of Ontario that connects people with dementia and their families to local Alzheimer Society programs and other community services while living in their own home
- Alzheimer Society of Ontario Support—brochures, publications, and a toll-free telephone contact for people with dementia and their family or caregivers
- Baycrest Seniors Support Program—a program that provides support to seniors living in the community and their caregivers by consistently staying in touch
Quality Statement 8. Caregivers Assessment and Support: Caregivers of people living with dementia are assessed on an ongoing basis and offered supports to address their individual needs.
Quality Statement 9. Safe Living Environment: People living with dementia have access to a safe living environment that meets their specific needs, including design modifications and a range of housing options.
- Housing Options for People Living With Dementia—a guide developed by the Canada Mortgage and Housing Corporation that provides guidance on increasing the safety of the home environment for people living with dementia and their caregivers
- Wandering—information from the Alzheimer’s Association about the risk of wandering while disoriented or confused in people with dementia, and tips for home modifications to help prevent it
Quality Statement 10. Access to Primary Care: People living with mild cognitive impairment or dementia have regular visits with a primary care physician or nurse practitioner who provides effective primary care that meets both their general health care needs and their specific needs related to cognitive impairment or dementia.
There are no specific tools identified for this statement.
Other Tools and Resources
The following are useful tools and/or resources for this quality standard topic that do not fall under any specific quality statements.
- Health Quality Ontario’s Quality Standards—other quality standards from Health Quality Ontario that focus on mental health issues, addictions, and chronic diseases may also be useful, including:
- Finding Your Way—a website from the Alzheimer’s Society of Ontario dedicated to help people living with dementia, their families, caregivers, and communities to prevent and prepare for the possibility of going missing
Comment below to describe your experience with these tools or share any others you have found useful!
This post is part of a series about how quality standards can be used to support quality improvement together, and provides a forum for people who are working on adopting the quality standards to share ideas and experiences. The introductory post can be found here.