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Recognizing Good Care

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Guiding Principles
Alzheimer's Association Recommendations

Guiding Principles

Always keep the person with dementia at the center of the care process. He or she must be respected and treated with dignity. Allow the person to make decisions about care whenever possible.

Good care includes ensuring safety and meeting basic needs but it also means the person should be involved in making decisions about their own care to the greatest extent possible.

Recognizing a person means knowing that person's history and special preferences. Personal Facts (PDF format)

Caregivers want to treat a whole person, not a patient. Let them know about the person's place of birth, childhood memories, family history, favorite hobbies, occupation, and morning or evening routines.

Care providers need to meet the special needs of individuals with dementia.

When you look for a care provider, ask about special training in dementia care. Find out how care providers are supervised and supported in their daily work.

Giving good care depends on understanding an individual's behavior and communication.

People with dementia may be unable to speak. So, their feelings and behaviors may speak for them. Care providers should try to understand a behavior's cause and consider the best solution.

The best environment makes a person feel independent and safe.

A good long-term care facility should feel comfortable and homelike. Feeling at home offers privacy. It also provides times to meet with other residents and family members. A homelike place offers residents choices, such as what activities to do and the chance to go outside safely.

Alzheimer's Association Recommendations for Nursing Homes and Assisted Living

Building on our tradition of advocacy to improve the quality of life for people with dementia, the Alzheimer’s Association launched the Campaign for Quality Residential Care to improve the quality of care for residents with dementia in assisted living and nursing homes. In each care area, we set goals.

Nutrition
Not eating enough or eating an unhealthy diet can worsen a resident's health. Our goals for nutrition are to:

offer systems that detect and prevent malnutrition
assure excellent nutrition, taking into account personal preferences
make mealtimes pleasant and enjoyable

Dementia may cause people to eat and drink less. They may not recognize that they're hungry or thirsty. In addition, some people with dementia can't smell and taste as well as before. They may also have trouble swallowing.

Pain management
People with dementia may suffer unnecessary pain because they can't always say that they hurt. Our goals for pain management are to:

ease pain and distress to give residents a better quality of life
treat pain as a vital sign, just like blood pressure, pulse, breathing and temperature
make sure pain management techniques match each resident's needs, conditions and risks

Poorly managed pain sometimes causes behavior problems, which can lead to unnecessary sedating medication.

Social engagement
Enjoying meaningful activities is part of good dementia care. Activities help residents stay active and feel happier. Our goals for social engagement are to:

offer meaningful daily activities that include a sense of community, choices and fun
design activities to do with residents, not to them or for them
respect residents' preferences, such as when they prefer to be alone

Meaningful daily social interactions offer a sense of dignity and self-esteem.

Wandering
Many of us assume that wandering is something that should be stopped, when in fact it is important to support a person’s movement. Our goals are to:

Encourage the person to move about safely and independently
Understand the meaning of a person’s wandering. It may indicate an unmet need such as hunger or boredom.

Wandering is helpful when it provides stimulation, promotes social contact or helps maintain mobility.

Falls
People with dementia are at increased risk for falls for a variety of reasons. Our goals are to:

Promote safety and mobility
Avoid physical restraints

Many falls are preventable. Look for hazards such as improper footwear, muscle weakness or lack of physical activity, poor lighting, clutter and uneven flooring such as throw rugs.

Physical restraints
A physical restraint is any method or device that restricts a person’s freedom of movement or access to his or her body and which the person cannot remove easily. Our goals are to:

Recognize and address underlying problems or unmet needs
Teach care providers techniques they can use to prevent, reduce or eliminate use of restraints

Physical restraints are generally harmful because of interference with daily activities such as eating, toileting, walking and socializing.

End of life care
Good end of life care meets a person’s changing needs and respects his or her preferences regarding end of life care. Our goals are to:

Ensure open and ongoing communication with the person, family and care team.
Provide support to families, other residents and staff throughout the dying process.
Encourage flexible care plans to adapt to daily changes in a person’s needs and wishes.

Hospices are increasingly involved in end of life care for people with dementia because they have broadened their admission criteria to include non-cancer diagnoses such as Alzheimer’s disease and other forms of dementia.