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Evidence to Improve Care

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.


The needs of people living with dementia are dynamic and complex. Individualized management from providers of various disciplines with expertise in dementia care is necessary. An interprofessional team allows for the delivery of dementia care through a multifaceted and collaborative approach to meet the individualized needs and preferences of each person living with dementia and of their caregivers. The care team’s composition should be flexible and adapt to the person’s changing health, social circumstances, needs, and goals. People living with dementia and their caregivers are an integral part of the team and should participate in decisions about their own care.

For People Living With Dementia

You should have access to a health care team with expertise in dementia care. Your health care team may include doctors, nurses, a social worker, a pharmacist, an occupational therapist, recreational staff, personal support workers, and others.

You and your caregivers should be treated as important members of your health care team. This means your questions, concerns, observations, and goals are discussed and incorporated into your care plan, and you are supported to play an active role in your own care.


For Clinicians

Ensure that people living with dementia are cared for by an interprofessional team with expertise in dementia care. Involve people living with dementia and their caregivers in decisions about their own care.


For Health Services

Ensure that systems, procedures, and resources are in place for people living with dementia to receive care from an interprofessional team with expertise in dementia care.

Process Indicators

Percentage of people living with dementia in the community who receive community-based dementia care from an interprofessional team with expertise in dementia care

  • Denominator: number of people living with dementia in the community
  • Numerator: number of people in the denominator who receive community-based dementia care from an interprofessional team including at least one physician or nurse practitioner and at least one other health care provider, all with expertise in dementia care
  • Data source: local data collection

Percentage of people living with dementia who receive community-based dementia care from an interprofessional team with expertise in dementia care in which they and their caregivers are integral team members

  • Denominator: number of people living with dementia who receive community-based dementia care from an interprofessional team with expertise in dementia care
  • Numerator: number of people in the denominator and their caregivers who feel they are integral team members
  • Data source: local data collection
Interprofessional team

This includes at least one physician or nurse practitioner and one other regulated health care professional trained in dementia care. Other regulated and unregulated providers on the team may include family physicians, nurses, nurse practitioners, psychologists, occupational therapists, pharmacists, behavioural support workers, social workers, caregivers, administrative staff, personal support workers, speech-language pathologists, physiotherapists, geriatricians, neurologists, geriatric psychiatrists, dietitians, therapeutic recreation staff, and spiritual care staff.

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