Quality Standard Details
Dementia: Care for People Living in the Community
- Publication Date
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2024-September-01
- Status
- Published
- Topic Area
- Mental Health and Addictions
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Dementia affects about 8.4% of Canadians aged 65 years and older. Notwithstanding this increased risk in older people, dementia also affects younger people: 2% to 8% of people diagnosed with dementia in Canada are younger than age 65. The debilitating effects of dementia have substantial personal and economic impacts on people with dementia and their care partners and families, as well as a considerable economic impact on the Canadian health care system and society more broadly. In 2020, the total estimated economic cost of dementia in Canada was $40.1 billion, including indirect costs on family and care partners through lost productivity.
Across the province, nearly half of people with dementia receiving long-stay home care had care partners who were distressed. Data also suggest that there are variations in the kind of care provided to people with dementia across regions. People with dementia living in areas with higher income tend to have greater rates of home care and are more likely to live at home than in a long-term care home.
This quality standard addresses care for people with dementia living in the community, including the assessment of people suspected to have dementia or mild cognitive impairment. The quality standard focuses on primary care, specialist care, hospital outpatient services, home care, and community support services. It also provides guidance on support for care partners of people with dementia.
This quality standard does not apply to care provided in an emergency department or hospital inpatient setting or to people living in long-term care homes, nor does it address specific aspects of palliative care for people with dementia.
For a quality standard that addresses care for people with dementia and the specific behaviours of agitation or aggression who are in an emergency department, admitted to a hospital, or in a long-term care home, refer to Behavioural Symptoms of Dementia: Care for People in Hospitals and Long-Term Care Homes.
For a quality standard that addresses palliative care, refer to Palliative Care: Care for Adults With a Serious Illness.
Quality Standard in Brief
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Quality Statement 1: Comprehensive Assessment and Diagnosis
People suspected to have mild cognitive impairment or dementia receive a comprehensive assessment when signs are first identified. If diagnosed with either condition, they are then reassessed on a regular basis or when there is a significant change in their condition.
Quality Statement 2: Interprofessional Care Team
People with dementia have access to community-based dementia care from an interprofessional team with expertise in dementia care, of which the person with dementia and their care partners are integral team members.
Quality Statement 3: Individualized Care Plan
People with dementia have an individualized care plan that guides their care. The plan identifies their individual needs, those of their care partners, and goals of care. The plan is reviewed and updated on a regular basis, including documentation of changing needs and goals and the person’s response to interventions.
Quality Statement 4: Named Point of Contact
People with dementia, their family, and their care partners have 1 or more named interprofessional care team members who serve as a point of contact to facilitate care coordination and transitions across settings.
Quality Statement 5: Education and Training for People With Dementia and Their Care Partners
People with dementia and their care partners have access to education and training on dementia and available support services.
Quality Statement 6: Education and Training for the Health Care Team
People with dementia receive care and services from health care team members who have education and training in dementia care.
Quality Statement 7: Access to Support Services
People with dementia and their care partners have access to support services that are individualized and meet their ongoing goals and needs.
Quality Statement 8: Care Partner Assessment and Support
Care partners of people with dementia are assessed on an ongoing basis and offered supports to address their individual needs.
Quality Statement 9: Safe Living Environment
People with dementia have access to a safe living environment that meets their specific needs, including design modifications and a range of housing options.
Quality Statement 10: Access to Primary Care
People with mild cognitive impairment or dementia have regular visits with a primary care physician or nurse practitioner who provides effective primary care that meets both their general health care needs and their specific needs related to cognitive impairment or dementia.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
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- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
