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Potential quality indicators

Psychosocial interventions

Quality indicators for people with dementia

Recommendation

Numerator

Denominator

A care plan for people with dementia, should be drawn up on the basis of the life history, social and family circumstances, and preferences (such as diet, sexuality and religion) of the person with dementia.

Number of people with dementia with registration of a care plan , including:

Life history,

social and family circumstances,

preferences (diet, sexuality, religion)

Total number of people with dementia at service

Treatment of dementia always involves at all stages emphasising the unique qualities of the individual with dementia and recognising the patients’ personal and social needs. The combination of different types of support, each tailored to the person and the situation is preferable over offering one type of support or a standard care package.

A. Number of people with dementia with registration of personal and social needs

in care plan and/or

medical record

B. Number of people with dementia with registration of a personalized shared care plan between the informal carer and care professional

A. Total number of people with dementia

at service

B. Total number of dementia patients that are offered support at service

Identify specific needs, including those arising from:

sensory impairment

communication difficulties

ill health

Number of people with dementia who receive a periodical needs assessment including:

sensory impairment

communication difficulties

ill health

Total number of people with dementia at service

Care plans should address the activities of daily living (ADL) that maximize independent activity, enhance function, adapt and develop skills, and minimise need for support.

Activities should include recreational, social, leisure and a structured day and activities should be adjusted to ensure that they are achievable with the limitations the patient has.

Number of people with dementia whose care plan includes both ADL and recreational, social, leisure and structured day activities.

Number of people with dementia at service

Healthcare professionals should be aware that many people with dementia can understand their diagnosis, receive information and be involved in decision making.

Number of people with dementia who have registered that diagnosis is discussed and that they were asked whether they wanted to hear explicit diagnosis and prognosis

Total number of people with dementia at service

Assess and monitor people with dementia for depressions and/or anxiety.

Number of people with dementia that are assessed periodically for depression and/or anxiety

Total number of people with dementia at service

People with dementia who develop non-cognitive symptoms that cause them significant distress or who develop challenging behaviour should be offered an assessment at an early opportunity to establish the factors likely to generate, aggravate or improve such behaviour. The assessment should include the person’s physical health and behavioural and functional analysis conducted by professionals with specific skills, in conjunction with carers and care workers. The assessment should lead to an individually tailored care plan and the coordination of care should be documented and reviewed regularly. The frequency of the review should be agreed by the carers and staff involved and documented.

Number of people with dementia who show non-cognitive symptoms that cause them significant distress or who develop challenging behavior that have a tailored care plan based on an assessment conducted by professionals including:

• physical health

• depression

• undetected pain or discomfort

• side effects of medication

• individual biography, including beliefs, spiritual and cultural identity

• psychosocial factors

• physical environmental factors

• specific behavioural and functional analysis.

The frequency of review of the care plan is agreed on by the informal carers and staff involved and documented in the notes.

Total number of people with dementia who show non-cognitive symptoms that cause them significant distress or who develop challenging behavior at service

Psychosocial interventions should be considered and should be tailored to the person’s preferences, skills, and abilities. Monitor response and adapt the care plan as needed.

A. Number of people with dementia whose care plan says that they receive psychosocial interventions, tailored to the person’s preferences, skills, and abilities.

B. Number of people with dementia for whom a psychosocial intervention was instituted for behavioral problems before pharmacological treatment was started

A. Total number of people with dementia at service

B. Total number of people with dementia at service, receiving pharmacological interventions for behavioral problems.

Care managers/coordinators should ensure that there is coordinated delivery of health and social care services, including a combined care plan, agreed by health and social services, that takes into account the changing needs of the person with dementia and the carers. A case manager, one or two assigned people who would maintain regular contact with the patient and the main caregiver should be involved in aiding patients with dementia and their caregivers.

Number of people with dementia who have an assigned professional who maintains regular contact with the patient and the main caregiver and ensures coordinated delivery of health and social care services

Number of people with dementia at service

Quality indicators for informal carers of people with dementia

Recommendation

Numerator

Denominator

Respite or short-break services should be available and include, for example, day-care, day and night sitting, adult placement and short-term and/or overnight residential care.

Number of carers of people with dementia for whom it is registered that respite or short-break care is offered to them

Total number of carers of people with dementia at service

Assess and monitor carers of people with dementia for anxiety and/or depression.

Number of carers of people with dementia that are periodically assessed for anxiety and/or depression

Total number of carers of people with dementia at service

Care plans for carers should include interventions tailored to carers needs and preferences such as individual or group psycho-education and training courses about dementia, services and benefits, and dementia-care problem solving. The general practitioner and/or other professionals should inform the family and caregivers of the local situation.

Number of carers of people with dementia who are offered psychosocial interventions, tailored to their needs and preferences

Total number of carers of people with dementia

Quality indicators for formal carers of people with dementia

Recommendation

Numerator

Denominator

Health and social care managers should ensure that all staff working with older people in the health, social care and voluntary sectors have access to dementia-care training (skill development) that is consistent with their roles and responsibilities. This should include comprehensive training on interventions that are effective for people with dementia.

Number of staff at care service/facility that receive specific dementia-care training at a regular basis, at least once a year

Number of staff at care service/

facility

 

 
 

Last Updated: jeudi 08 octobre 2009

 

 
  • Acknowledgements

    The EuroCoDe project received financial support from the European Commission. Neither the European Commission nor any person acting on its behalf is responsible for any use that might be made of the following information. Alzheimer Europe also gratefully acknowledges the support it received from Fondation Médéric Alzheimer for this project.
  • European Union
  • Fondation Médéric Alzheimer
 
 

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