This page provides information on strategies for caring for people with cognitive impairment. It provides links back to the Commission’s resource, A better way to care as well as links to external resources, videos and courses to aid in furthering your education on the topic.
A better way to care
The Commission has developed A better way to care resources to guide health service managers, clinicians and consumers in improving care of people with cognitive impairment. The resources follow a pathway with three main steps:
- Be alert to delirium and the risk of harm for patients with cognitive impairment
- Recognise and respond to patients with cognitive impairment
- Provide safe and high-quality care tailored to the patient’s needs.
The resources describe evidence based strategies that collated from research, a range of existing guidelines and current good practice. Links to further information are provided.
Actions for health service managers
This resource is for health service managers, executives and owners of health services who are responsible for achieving strategic change, and developing programs and projects to improve safety and quality. It links to the existing National Safety and Quality Health Service Standards.
The relevant pages in Actions for Health Service Managers are provided, following the pathway:
|Delirium risk and risk of harm||12-14 and 30-36|
|Capacity, informed consent and substitute decision making||15- 19|
|Cognition and cognitive screening||38 – 41|
|Delirium assessment and re-assessment||43 and 56|
|Comprehensive assessment and care plan||44-45 and 57|
|Communication||60 and 81|
|Partnership with consumers||63 and 81-82|
|Delirium prevention and treatment||63 and 82|
|Behavioural changes including limiting the use of antipsychotics and other psychoactive medicines||64 and 84 – 85|
|Advance care planning||30, 45 and 85|
|Aboriginal and Torres Strait Islander considerations||58|
|Hospital environment||67 and 83|
|Planning transitions||67 and 83|
Actions for clinicians
Actions for clinicians is for clinicians who are responsible for the care and treatment of patients with cognitive impairment.
Actions for Clinicians is also available as an app:
Actions for consumers
Actions for consumers is designed for patients with cognitive impairment, their carers and families and outlines what they can do during a hospital stay to assist in the provision of safe and high-quality care.
Advance care planning
This report Future planning and advance care planning explains important considerations for people with dementia and other forms of cognitive decline.
Allies in Dementia Health Care Project, a joint initiative of Alzheimer’s Australia and the NSW Agency for Clinical Innovation has developed resources that provide an overview of the important role of allied health in supporting people with dementia.
Behavioural changes including limiting the use of antipsychotics and other psychoactive medicines
Dementia Training Australia provides a service and resources to assist staff in aged care and health care facilities to understand the causes of “responsive behaviours” and to find ways to avoid or reduce them. The service can complement services provided by Dementia Support Australia (DSA).
The 2016 NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People Clinical Practice Guidelines and Principles of Care for People with Dementia, provides recommendations for the assessment and management of behavioural and psychological symptoms of dementia
- Antipsychotics & Dementia: Managing Medications video on Alzheimers Australia’s Detect Early website, features Professor Henry Brodaty (Psychogeriatrician), Dr Julian Pierre (GP) and Tim Perry (Consultant Pharmacist) and discusses the use of anti-psychotics for people with dementia and alternative solutions for behavioural and psychological symptoms of dementia
- Older people in hospital Toolkit – Cognition
- MAXCOG:Maximising Cognition are resources developed for people with mild cognitive impairment and early dementia that provide techniques and strategies to manage difficulties related to thinking, memory, language and vision
- Alzheimer’s Australia Communication Help Sheet, outlines possible changes in communication as a result of dementia and suggests ways families and carers can help. It also includes some personal tips on communication written by a person with dementia
- Alzheimer’s Australia Cultura is a website and an app that provides a database of resources and cultural information to assist health care workers learn about specific cultural needs
- Alzheimer’s Australia Dementia Language Guidelines , promote use of non-stigmatising language when talking about dementia and people with dementia
- Alzheimer’s Australia brochure “Talk to me”, provides communication tips for talking to people with dementia
- Alzheimer’s Society (UK) This is me tool, provides a simple and practical tool that people with dementia can use to tell staff about their needs, preferences, likes, dislikes and interests
- Sight, perception and hallucinations in dementia is a factsheet from the UK Alzheimer’s Society that outlines the vision and perception difficulties that a person living with dementia can experience and suggests way of providing support. These difficulties are a reminder of the importance of understanding not only cognitive changes but also the perceptual, visual and language difficulties experienced by a person with cognitive impairment and that these will be different for each person and will change over time.
- The Focus on the person form is designed to help family carers inform hospital staff about a person living with dementia. It was developed by Toye et al from Curtin University and Sir Charles Gairdner Hospital, with funding from the Dementia Collaborative Research Centre: Carers and Consumers.
- Aboriginal and Torres Strait Islander Communities resources are provided on the Alzheimer’s Australia website
- Allied health professionals and you: a guide for people living with dementia and their carers is the consumer guide from the Allies in Dementia Health Care Project, a joint initiative of Alzheimer’s Australia and the NSW Agency for Clinical Innovation
- Alzheimer’s Australia website
- Alzheimer’s Australia-Victoria Online Dementia Support
- Alzheimer’s Australia Delirium and Dementia – Q&A sheet, explains what delirium is, and, how it relates to people with dementia
- Australasian Delirium Association Community information on delirium
- Consumer Companion Guide – The 2016 NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People Clinical Practice Guidelines and Principles of Care for People with Dementia has a Consumer Companion Guide that enables people with dementia and their carers to be fully informed about what kind of care and treatment to expect
- Healthdirect, a government-funded service, providing quality, approved health information has information on Dementia and on Dementia and Delirium
- Information in other languages is provided on Alzheimer’s Australia website
Resources about delirium are included under consumer information, programs, educational videos, online learning and training courses and international resources.
The Australasian Delirium Association aims to promote better understanding of delirium through leadership, education, support, resources, research and partnerships.
- Key Principles for Improving Healthcare Environments for People with Dementia provides design guidance for new and refurbished inpatient units and is an update of the Adapting the Ward for People with Dementia booklet first published by NSW Health in 2003
- The Dementia Enabling Environment Project (DEEP) Virtual Information Centre provides practical tips, guides and resources to modify homes, care environments, gardens and public buildings to help a person with dementia to lead as full and independent life as possible
- At Home with Dementia provides practical, general suggestions for addressing problems commonly faced by people living with dementia in the home environment, noting that solutions will different for each individual and will depend on the particular difficulties they are experiencing that will change over time
- NPS Medicinewise and Alzheimer’s Australia latest information on Medicines & Dementia, including strategies for tips for good medicine management
Other forms of cognitive impairment
Centre for Developmental Disability Health Victoria Working with people with an intellectual disability fact sheet, provides strategies for good health care and for communicating with people with an intellectual disability
Dementia and Chronic Conditions Series Toolkits, on the Alzheimer’s Australia website, are designed to improve support for people living with cognitive impairment and other chronic conditions.They include HIV-associated neurocognitive disorder (HAND), diabetes and dementia, and dementia, stroke and coronary heart disease.
Living with Intellectual Disability and Dementia video produced Alzheimer’s Australia NSW, provides a resource for services working in the disability sector and for family members and friends who are concerned about signs of cognitive decline in a relative or friend who lives with an intellectual disability
NOFASD Australia is the website for the national peak organisation representing the interests of individuals and families living with Fetal Alcohol Spectrum Disorders (FASD) and provides a range of information resources.
- Volunteer Dementia and Delirium Care Implementation and Training Resource provides a comprehensive suite of materials required to establish and implement an evidence-based dementia and delirium care hospital volunteer program. The program aims provide emotional support and practical assistance to patients with dementia and delirium or those patients with identified risk factors for delirium.
- NSW Confused Hospitalised Older Persons Program (CHOPS)
- The Dementia Care in Hospitals Program (DCHP)
- Older people in hospital (Vic)
- TOP 5 program (NSW)
- The Victorian Geriatric Training Program Learning Modules for Junior Doctors
- On My Mind Delirium
- On My Mind Dementia and Delirium
- On My Mind High Quality Care
- The View from Here – (to be released shortly by Dementia Training Australia)
- Delirium – Care of Confused Hospitalised Older Person: An Education Services for Health Professionals – Watch the videos for Delirium – Care of Confused Hospitalised Older Person: An Education Services for Health Professionals
- Barbara’s Story
- Delirium: a daughter’s experience – Sandra’s story (Healthcare Improvement Scotland )
- Patient Delirium Experience – a patient describes his experience of post operative delirium in a video that highlights how distressing the experience can be
- Dementia Training Australia is a consortium of experts in dementia care and workforce training, funded by the Australian Government to provide dementia-specific training for aged care, health care professionals, undergraduate trainees, and a range of other professionals and community service providers.
- Understanding Dementia Massive Open Online Course (MOOC) University of Tasmania
- NSW Health Dementia Care Competency and Training Network
- Western Australian Centre for Health and Ageing E-Ageing
- Learn about Delirium
- Vanderbilt University Medical Centre ICU Delirium website provides education about delirium in the ICU for health professionals and patients and families
- University of Nottingham Improving Dementia Education and Awareness (IDEA) website provides online training resources
Hospital Elder Life Program (HELP) – Dr. Sharon K. Inouye and her colleagues at the Yale University School of Medicine originally designed HELP to prevent delirium and it has developed into a comprehensive program to optimise the care of older people in the hospital
(US) Health Research & Educational Trust – Preventing Iatrogenic Delirium Change Package: 2016 is a change package for hospitals that provides a range of strategies and specific actions to prevent delirium.