NICE Guidelines for Dementia

The National Institute for Clinical Excellence (NICE) was developed through the United Kingdom's National Health Service. The institute's clinical guidelines provide recommendations regarding the care and treatment of people with dementia. While the document offers many specific details of care, all recommendations fall under some basic guiding principles.

Personal Dignity

The guidelines state that even though an individual has dementia, they and their caregivers should always be treated with dignity and respect. The principles discuss the necessity of identifying the needs of the patient---as well as their caregivers---as they relate to age, gender, ethnicity and religion. Above all, concerns of the patient and their partner or caregivers need to be undertaken with sensitivity and tact.

Personal Care

The NICE guidelines encourage involvement and input from caregivers and relatives in helping assess patients and their care regimen. The guidelines recommend accommodating the patient's personal preferences with regard to diet, religion and sexuality. In addition, it is assumed that the adult patient is able to make their own decisions regarding their care until otherwise documented.

Other Considerations

The guidelines recognize that dementia patients sometimes suffer from symptoms that are not of a cognitive nature and that those symptoms may cause them considerable distress. Problems with daily activities and personal care can be frustrating, and there are often sleep disturbances, restlessness and a lack of understanding as to why the patient is in a restricted ward. Health-care professionals and caregivers need to be aware of these possibilities so that they can address them properly.

Relationships

Communication is essential between the patient (when possible), the caregivers, and health-care and social-work professionals. All parties should be kept abreast of the specific needs that occur such as physical disabilities, communication problems, poor health, oral-health problems, nutrition issues and learning disabilities in order to ensure successful treatment.

Risk Management

There are risks involved with all dementia patients, who may be vulnerable to neglect and mistreatment. All individuals involved in the care of people with dementia should be educated on policies regarding adult protection and are expected to abide by them. In addition, staff members who are responsible for the care of patients with dementia should be aware of any physical, psychosocial and environmental problems.

Advance Decisions

It is important to receive advance decisions from the patient before he loses the ability to communicate his wishes. Decisions regarding future treatment or the refusal of such treatment, power of attorney and his preference of where he would like to receive care should be discussed with the patient and put into place as soon as possible.

References

• NICE Guidelines for Dementia