Quality statement 5: Activities to promote wellbeing

Quality statement

People with dementia are supported to choose from a range of activities to promote wellbeing that are tailored to their preferences. [2013, updated 2019]

Rationale

The symptoms of dementia make it harder for a person to take part in activities, to engage socially, to maintain their independence, to communicate effectively, to feel in control and to care for themselves. Providing enjoyable and health-enhancing activities that are suitable for the stage of dementia can help with this. Understanding the activities that a person prefers, and thinks are suitable and helpful, with the input of family and carers if needed, and adapting them to their strengths and needs, will make a person more likely to engage with the activities offered.

Quality measures

Structure

a) Evidence of local arrangements to ensure that a range of activities are available that promote wellbeing for people with dementia.

Data source: Local data collection, for example, service specifications.

b) Evidence of local arrangements to ensure that people offering activities to promote wellbeing to people with dementia discuss the person's preferences with them and tailor the activities to these.

Data source: Local data collection, for example, service protocols.

c) Evidence of local arrangements to support access to a range of activities that promote wellbeing for people with dementia, such as transport options.

Data source: Local data collection, for example, service specifications.

Process

a) Proportion of people with dementia who discuss activities to promote wellbeing at a review of their care plan.

Numerator – the number in the denominator who discuss activities to promote wellbeing at a review of their care plan.

Denominator – the number of people with dementia.

Data source: Local data collection, for example, local audit of care plans.

b) Proportion of people with dementia who take part in activities to promote wellbeing that are tailored to their preferences.

Numerator – the number in the denominator who take part in activities to promote wellbeing that are tailored to their preferences.

Denominator – the number of people with dementia.

Data source: Local data collection, for example, local audit of patient records.

Outcomes

a) Self-reported or carer-reported level of satisfaction with activities to promote wellbeing.

Data source: Local data collection, for example, patient surveys.

b) Self-reported or carer-reported quality of life of people with dementia.

Data source: Local data collection, for example, a survey of people with dementia. The Dementia Quality of Life Measure (DEMQOL) is a patient-reported outcome measure to enable the assessment of health-related quality of life of people with dementia.

c) Level of independence of people with dementia.

Data source: Local data collection, for example, a survey of people with dementia.

What the quality statement means for different audiences

Service providers (such as local authorities, community care providers, dementia adviser services, community old age psychiatry services and memory clinics) ensure that systems are in place for people with dementia to discuss their preferences and needs, to choose activities to promote wellbeing that are tailored to these, and to access the activities they have chosen.

Health and social care practitioners (such as occupational therapists, community psychiatric nurses, psychologists, care home nurses, healthcare assistants, activities coordinators, dementia advisers, wellbeing advisers and social workers) have a discussion with the person with dementia, and their families and carers if appropriate, about life experiences, circumstances, preferences, interests, strengths and needs. They are aware of the activities to promote wellbeing that are available locally and, based on this discussion, they help the person with dementia to choose activities that suit their preferences and needs.

Commissioners (such as local authorities and clinical commissioning groups) ensure that activities to promote wellbeing are available for people with dementia. They specify that providers offer people with dementia these activities based on a discussion of their preferences and needs.

People with dementia talk about their life experiences, circumstances, preferences, interests, strengths and needs with a professional and people involved in their care. They are told about suitable activities for improving their wellbeing, such as joining a local choir or walking group, and are supported to access the activities they choose.

Source guidance

Dementia: assessment, management and support for people living with dementia and their carers (2018) NICE guideline NG97, recommendation 1.4.1

Definitions of terms used in this quality statement

Activities to promote wellbeing

Activities such as exercise, aromatherapy, art, gardening, baking, reminiscence therapy, music therapy, mindfulness and animal-assisted therapy.

[NICE's guideline on dementia, full guideline and expert opinion]

Tailored to their preferences

Interventions that the person with dementia considers to be feasible, acceptable, enjoyable, suitable and helpful. The activities offered should be based on an understanding of that individual's unique set of life experiences, circumstances, preferences, strengths and needs.

[NICE's guideline on dementia, full guideline]

Equality and diversity considerations

Offers of activities need to take account of any mental health conditions and learning or physical disabilities. Any information provided should be accessible to people with additional needs, such as physical, sensory or learning disabilities. Recommendation 1.1.2 in the NICE guideline on dementia highlights that if needed, other ways of communicating (for example, visual aids or simplified text) should be used.