Lack of specialised tools puts dementia care improvements at risk
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Recent studies from Flinders University’s Caring Futures Institute have revealed a critical gap in the tools used to measure and improve care quality for dementia patients in aged care facilities. Despite over half of all aged care residents having dementia, current quality assessment instruments are failing to adequately capture their experiences and needs.
Two studies conducted by the institute reveal significant gaps in the tools used to monitor care quality for dementia patients, highlighting an urgent need for more robust and inclusive instruments.
“Quality of care measures, including patient-reported experience measures (PREMs), are vital tools in ensuring the experiences of those in our health and aged care sector are heard and understood, so improvements to care can be made,” says Associate Professor Rachel Milte from Flinders’ College of Nursing and Health Sciences.
The first study conducted a comprehensive review of existing quality of care instruments used in long-term care facilities. Out of 16 identified tools, only two were specifically created for older people with dementia, and three were modified to accommodate those with mild to moderate dementia. Furthermore, none of these instruments had undergone full psychometric testing to ensure their accuracy and effectiveness.
“Many existing instruments rely heavily on text-based formats, which can be challenging for people with cognitive impairments. There is a pressing need for tools that use more accessible communication methods such as images, pictographs, and audio-visual materials,” explains Associate Professor Milte.
The second study examined the use of PREMs for populations with diverse communication needs, including those with cognitive impairments, mental health concerns, and children. The researchers found that most PREMs are not adequately tailored for people with dementia and often lack sensitivity to the specific aspects of care that matter most to them.
“Current PREMs tend to prioritise organisational and clinical indicators rather than personal experiences, which can lead to an incomplete understanding of care quality from the patient’s perspective,” says Professor Kate Laver from Flinders’ Caring Futures Institute.
Professor Laver emphasises the need for dementia-specific PREMs that prioritise the voices of patients themselves, rather than relying on proxies like family members or healthcare staff who may not fully understand or accurately represent the patient’s needs and preferences.
As Australia’s population ages and the prevalence of dementia increases, the need for validated tools that reflect the voices and experiences of people living with dementia becomes more critical. “These tools will be key to understanding and monitoring self-reported healthcare experiences for people with moderate to advanced dementia, ensuring that consumer voices are elevated and platformed to inform quality improvement throughout the sector,” concludes Associate Professor Milte.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
