Practice recommendations for assisted living residences and
nursing homes

• “Person-centered”

• Comprehensive assessment of a resident’s abilities/needs

• Care planning and provision

• Strategies for addressing behavioral and communication

• Appropriate staffing patterns

• Environment that fosters community

  Routine Assessment Approach

Food and
Fluid Consumption

To maintain proper nutrition and hydration, avoid health complications, and promote mealtimes as enjoyable activities.

• Difficulty chewing and swallowing, or changes in swallowing abililty

• Poor utensil use

• Refusing substitutions

• Low attentiveness to a meal or wandering away during the meal

• More than 25 percent of food uneaten during a meal

• Evaluate cause of swallowing difficulties

• Engage residents in the mealtime experience and stimulate appetite

• Encourage residents to function independently whenever possible

• Provide a pleasant, familiar dining environment free of distractions

• Prepare food to maximize acceptance

Pain Management

To ease distress associated with pain, improve quality of life, prevent behavioral symptoms, and unnecessary use of psychotropic drugs.

• Site of pain

• Type of pain

• Effect of pain on the person

• Pain triggers

• Acute or chronic pain

• Positive and negative consequences of treatment

• PREVENTION of pain

• Non-pharmacological approach (i.e. relaxation, physical activities, superficial heating)

• Analgesics or narcotic pain medications (Consider side effects, including those affecting dementia and cognitive functioning)

• Appropriate referrals

Social Engagement and Meaningful Activities

To offer opportunities for providing a context with personal meaning, a sense of community, choices and fun.

• Capacity for physical movement

• Capacity for mental stimulation

• Interest in social interaction

• Desire and ability to participate in religious and spiritual practices

• Cultural values and appreciation

• Various specific recreational interests and preferences

• Design interactions to do with—not to or for—the resident

• Make available activity materials

• Encourage residents to use their remaining skills in daily activities

• Provide chances for involvement in the community

• Acknowledge that some residents with dementia experience increased confusion, agitation and movement in the early evening

• Consider the resident’s level of functioning, group dynamics, and overall mood


Adapted from: Alzheimer’s Association. Dementia care practice recommendations for assisted living residences and nursing homes. Chicago (IL): Alzheimer’s Association; 2009. 15p.

(Rev. 10/2015)