Care for People in Hospitals and Long-Term Care Homes
Quality standards are sets of concise statements designed to help health care teams easily and quickly know what care to provide, based on the best evidence.
See below for a summary of the quality standard or download it for more detailed statements.
Download the Quality Standard
Quality Statement 1: Comprehensive Assessment
People with dementia and symptoms of agitation or aggression receive a comprehensive interprofessional assessment when symptoms are first identified and after each transition in care.
Quality Statement 2: Individualized Care Plan
People with dementia and symptoms of agitation or aggression have an individualized care plan that is developed, implemented, and reviewed on a regular basis with care partners and agreed upon by substitute decision-makers. Ongoing review and update of care plans includes documentation of behavioural symptoms and the person’s responses to interventions.
Quality Statement 3: Individualized Nonpharmacological Interventions
People with dementia and symptoms of agitation or aggression receive nonpharmacological interventions that are tailored to their specific needs, symptoms, and preferences, as specified in their individualized care plan.
Quality Statement 4: Indications for Psychotropic Medications
People with dementia are prescribed psychotropic medications to help reduce agitation or aggression only when they pose a risk of harm to themselves or others or are in severe distress.
Quality Statement 5: Titrating and Monitoring Psychotropic Medications
People with dementia who are prescribed psychotropic medications to help reduce agitation or aggression are started on low dosages, with the dosage increased gradually to reach the minimum effective dosage for each patient, within an appropriate range. Target symptoms for the use of the psychotropic medication are monitored and documented.
Quality Statement 6: Switching Psychotropic Medications
People with dementia who are prescribed psychotropic medications to help reduce agitation or aggression have their medication discontinued and an alternative psychotropic medication prescribed if symptoms do not improve after a maximum of 8 weeks. Ineffective medications are discontinued to avoid polypharmacy. The reasons for the changes in medication and the consideration of alternative psychotropic medications are documented.
Quality Statement 7: Medication Review for Dosage Reduction or Discontinuation
People with dementia who are prescribed psychotropic medications to help reduce agitation or aggression receive a documented medication review on a regular basis to consider reducing the dosage or discontinuing the medication.
Quality Statement 8: Physical Restraint
People with dementia are not physically restrained to manage symptoms of agitation or aggression.
Quality Statement 9: Informed Consent
People with dementia and symptoms of agitation or aggression are advised of the risks and benefits of treatment options, and informed consent is obtained and documented before treatment is initiated. If a person with dementia is incapable of consenting to the proposed treatment, informed consent is obtained from their substitute decision-maker.
Quality Statement 10: Specialized Interprofessional Care Team
People with dementia and symptoms of agitation or aggression have access to services from an interprofessional team that provides specialized care for the behavioural and psychological symptoms of dementia.
Quality Statement 11: Education and Training for Clinicians
People with dementia and symptoms of agitation or aggression receive care from clinicians with education and training in the assessment and management of dementia and its behavioural symptoms.
Quality Statement 12: Education and Training for Care Partners
Care partners of people with dementia and symptoms of agitation or aggression have access to comprehensive education and training on dementia and its associated behavioural symptoms. This education and training includes management strategies that are consistent with people’s care plans.
Quality Statement 13: Appropriate Care Environment
People with dementia and symptoms of agitation or aggression whose behavioural symptoms have been successfully treated are transitioned to an appropriate care environment as soon as possible.
Quality Statement 14: Transitions in Care
People with dementia and symptoms of agitation or aggression who transition between settings have a health care team or clinician who is accountable for coordination and communication. This team or clinician ensures the transmission of complete and accurate information to the family, care partners, and receiving health care team prior to the transition.