1 September 2006
Alzheimer's Association - Disease Specific Society
Summary,

GUIDELINE OBJECTIVE(S)

To enhance the quality of life of people with dementia by improving the quality of dementia care in assisted living residences and nursing homes

TARGET POPULATION

Residents of assisted living facilities and nursing homes

INTERVENTIONS AND PRACTICES CONSIDERED

Dementia Care

1. Holistic assessment
2. Regular formal assessments
3. Refer to other professionals as appropriate
4. Care planning involving resident, family, and staff
5. Provide person-centered care
6. Provide opportunities for residents to express themselves
7. Medication and non-pharmacological treatment
8. Training and management of staff
9. Provide positive and safe environment

Food and Fluid Consumption

1. Nutrition screening and thorough assessment
2. Ongoing monitoring of food and fluid intake
3. Staff engagement in mealtime experience
4. Provide pleasant, familiar dining environment and positive social environment
5. Provide opportunity for residents to drink fluids throughout the day

Pain Management

1. Pain assessment
2. Referral to other health care professional, as appropriate
3. Staff documentation of pain assessment
4. Pain prevention with medication or non-pharmacologic approaches
5. Analgesics or narcotic pain medication

Social Engagement

1. Formal initial assessment
2. Staff involvement in resident's social engagement
3. Social engagement plan
4. Encourage activity through environment
5. Encourage use of remaining skills in daily activities

Management of Wandering Residents

1. Assessment of resident's history and patterns of wandering and associated risks
2. Care planning that promotes patient mobility and safety
3. Additional staff assistance for newly admitted residents
4. Ensure that wandering residents have adequate nutrition and hydration
5. Accompany wandering residents to ensure safety
6. Staff training on the consequences of unsafe wandering
7. Create substitute physical activities

Management of Resident Falls

1. Resident history and patterns of falling and initial assessment
2. Identification of resident risk factors
3. Evaluation of environmental conditions related to falls
4. Care planning that promotes patient mobility and safety
5. Refer to other professionals as appropriate
6. Staff training on fall prevention
7. Promote a regular sleep-wake cycle
8. Exercise programs to maintain or improve resident function, posture, and balance
9. Modify environment to prevent falls

Physical Restraint-Free Care

1. Initial assessment and history
2. Regular comprehensive assessment
3. Residences; self-assessment of their capacity to provide a restraint-free environment
4. Care planning
5. Staff and family education
6. Developing restraint-reduction plan
7. Modify environment to eliminate restraints

MAJOR OUTCOMES CONSIDERED

* Effectiveness of interventions to alleviate psychiatric and behavioral symptoms
* Effectiveness of interventions to minimize limitations in activities of daily living
* Effectiveness of interventions to prevent falls and unsafe wandering
* Effectiveness of interventions to reduce and eliminate use of restraints
* Quality of life