Skip to main content

Evidence to Improve Care

Dementia

Care for People Living in the Community

Click below to see a list of brief quality statements and scroll down for more information.


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.

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.

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.

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.

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.

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.

Quality Statement 8: Caregiver 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.

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.

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.


People living with dementia should have a living environment that is safe and helps them to live as comfortably and independently as possible. As the disease progresses, dementia impacts peoples’ ability to interact with and make sense of their environment. Environments that are familiar, home-like, and easy to understand are important.

Over the course of a person’s dementia, living environments need to be modified to help the person navigate their surroundings, support their independence, and reduce their feelings of confusion and stress. Design modifications may include nonslip floor coverings, handrails in the shower and beside the toilet to provide support and balance, heat and smoke sensors, and memory cues.

When people living with dementia are no longer able to live safely and independently in their home, they may consider moving to a more supported care setting, such as an assisted-living facility, a dementia-friendly group home, a retirement residence, or a long-term care home.

Housing options for people living with dementia should ideally be financially accessible and in close proximity to their caregivers and family. They should meet the needs and preferences of both the person and their caregivers. Spouses wishing to remain living with each other should have access to environments where this is possible.

For Caregivers

You should have a safe living environment that meets your needs. Your health care team can help you understand what changes might be needed, such as memory cues or better lighting. Your team can also connect you with services to assess your living environment. Depending on your needs, you may decide to move to a different living environment.


For Clinicians

Ensure connection with service providers who can help ensure that housing is safe and meets the needs of the person living with dementia and their caregivers.


For Health Services

Ensure that systems, processes, and resources are in place to a make people’s living environments safe and to address individual needs. This includes appropriate design modifications and housing options offering more supported living environments.

Process Indicator

Percentage of people living with dementia in the community who reside in a safe living environment that meets their specific needs

  • Denominator: number of people living with dementia in the community
  • Numerator: number of people in the denominator who reside in a safe living environment that meets their specific needs
  • Data source: local data collection
Safe living environment

A living environment that helps the person living with dementia navigate their place of residence and their community and that supports their caregivers by helping to keep the person safe. The environment should have appropriate stimuli and address potential safety and security hazards inside and outside the residence (e.g., stoves and ovens, unlocked doors, clutter on floors and surfaces, and unfenced yards). A person’s living environment needs should be documented in their individualized care plan (see Quality Statement 3).

Design modifications

These are tailored to the person’s needs and preferences and adapted as needed during the course of their dementia.

Modifications can include changes to:

  • Lighting
  • Surfaces to minimize reflections and glare
  • Floor coverings
  • Colour schemes and contrasts
  • Noise and room acoustics (e.g., locate bedrooms away from, and not adjacent to, high-noise areas, minimize background noise)

Modifications can include the use of:

  • Signage
  • Glass-fronted cupboard doors so people can see what is inside
  • Memory cues
  • Notice boards
  • Assistive technology (e.g., prompts and reminders, orientation devices) and devices (e.g., handrails)
  • Safety devices for hazardous items, such as heat and smoke sensors for the stove
  • Fencing in yards
Housing options

These include:

  • The person’s own home (independent living)
  • Assisted-living facilities or supportive housing, such as seniors’ housing, retirement residences, or retirement communities
  • Dementia-friendly group homes
  • Long-term care homes
 

Let’s make our health system healthier

Join Our Patient, Family and Public Advisors Program

Patients, families and the public are central to improving health quality.


Man smiling

Sign up for our newsletter

Are you passionate about quality health care for all Ontarians? Stay in-the-know about our newest programs, reports and news.

Health Quality Connect - Health Quality Ontario's newsletter - on an iPad and a cell phone