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Latest Dementia Care Practice Recommendations Emphasize Person-Centered Care

The Alzheimer's Association has released new dementia care practice recommendations aimed at helping nursing homes, assisted-living facilities, and other long term care and community care providers deliver optimal quality, person-centered care for those living with Alzheimer's and other dementias. The recommendations have been posted online and as a supplement to The Gerontologist, a peer-reviewed journal of The Gerontological Society of America. 

The Alzheimer's Association 2018 Dementia Care Practice Recommendations outline 56 recommendations across 10 content areas, grounded in the fundamentals of person-centered care. The Gerontologist devotes an article to each content area, providing evidence and expert opinion supporting each recommendation.

These recommendations were developed by 27 dementia care experts convened by the Alzheimer's Association and are based on a comprehensive review of current evidence, best practice, and expert opinion. The recommendations seek to better define quality care across all care settings, and throughout the disease course. They are intended for professional care providers who work with individuals living with dementia and their families in long-term and community-based care settings.

"Since its inception, the Alzheimer's Association has been a leader in outlining principles and practices of quality care for individuals living with dementia," says Sam Fazio, PhD, lead author and director of quality care and psychosocial research at the Alzheimer's Association. "These recommendations reflect the most current research and best practices to help ensure high-quality, person-centered care for people living with Alzheimer's in long-term and community-based settings."

It is estimated that nearly 60% of older adults with Alzheimer's or other dementias reside in the community (outside a hospital or clinical setting). About 25% of these individuals live alone, but the remainder receives care from family members, unpaid caregivers, and community-based and residential care providers. By age 80, 75% of people with Alzheimer's dementia are admitted to a nursing home. The new recommendations are aimed at guiding care in these settings.

In addition to updating and enhancing previous recommendations in areas familiar to the dementia care community, the recommendations break important new ground. Most notably, the recommendations offer guidance to community-based and residential care providers on detection and diagnosis and ongoing medical management—topic areas typically reserved for clinicians. Recommendations in these two areas are written specifically for nonphysician care providers and address what these providers can do to help with these important aspects of holistic, person-centered dementia care.   

"Detection and diagnosis, and medical management are critical, vital areas of care. While clinicians must continue to take a lead role in these areas, there are important contributions dementia care providers can make to improve outcomes in these areas," Fazio says. "Our recommendations outline appropriate actions dementia care providers can make to complement and enhance the work clinicians are doing. Having both groups focus on these critical areas will result in better care for people struggling with this disease."

Other areas covered by the recommendations include the following:

  • fundamentals of person-centered care;
  • assessment and care planning;
  • information, education, and support;
  • ongoing care for behavioral and psychological symptoms of dementia;
  • support of activities in daily living;
  • staffing;
  • supportive and therapeutic environments; and
  • transitions and coordination of services.

The Alzheimer's Association will share the recommendations with policymakers and the dementia care community formally during a Capitol Hill event on February 14 with special guest remarks by Senator Susan Collins (R-ME) and Senator Catherine Cortez Masto (D-NV). Dementia care experts who developed the recommendations will provide deeper context and explanation behind the new recommendations. 

In conjunction with the new recommendations, the Alzheimer's Association is releasing a separate report that examines quality care through the eyes of people living with the disease. "A Guide to Quality Care from the Perspectives of People Living with Dementia" includes survey data and interviews from individuals living in the early stage of Alzheimer's or other dementias. It offers insights into how those most affected by the disease view quality care and what they want from care providers and caregivers during their difficult journey.  

There are an estimated 5.5 million Americans living with Alzheimer's disease today. It is the sixth-leading cause of death, and the only disease among the top 10 causes of death that cannot be prevented, cured, or even slowed. The number of Americans living with Alzheimer's is projected to reach nearly 14 million by 2050, unless more effective treatments are advanced.

Source: The Gerontological Society of America