Quality assurance

Background: Shared decision-making (SDM) is a means of allowing people with dementia to take part in making choices, be autonomous and participate in social activities. Involving them in SDM is an important way of promoting social health. However, including families and dementia residents in decision-making can be challenging for care staff working in nursing homes. The objective of this study was to identify barriers and facilitators regarding the implementation of an SDM framework for care planning in two nursing homes, one in Italy and one in the Netherlands.

Aim. This paper is a report of a study conducted to explore the determinants of satisfaction with health and social care services in the last 3 months and 3 days of life as reported by bereaved relatives of those who died from a stroke in an institutional setting.

Background. There is limited research about how best to meet the needs of those who die from stroke. A thorough understanding of the determinants of satisfaction with end of life care is crucial for effective service provision to increase awareness of the needs of dying patients.

This quality standard covers the treatment and management of psychosis and schizophrenia (including related psychotic disorders such as schizoaffective disorder, schizophreniform disorder and delusional disorder) in adults with onset before the age of 60 years in primary, secondary and community care. It does not cover adults with transient psychotic symptoms.

Aims and objectives.  Few surveys have been carried out documenting the quality of life for non-cancer patients in general district hospitals reaching the final trajectory towards death. We carried out a survey of 80 patients facing the final stages of their chronic illness as well as their carers and hospital staff.

The authors reflect on the importance of learning and development for transforming dementia and end-of-life care. Topics discussed include dependency of quality of dementia care on care providers including registered practitioners, support staff and informal carers, focus on person-centred care and building the leadership skills and confidence to influence care given by diverse and multiprofessional team.

Changes to approaches in dementia care and subsequent services over the last decade have meant that quality of care for people with dementia and their carers has undoubtedly improved. However, few in-depth dementia service evaluation studies are documented. Those that are tend to focus on traditional evaluation measures such as length of stay or functional improvement, or they concentrate on the perspectives of carers. This study used multiple methods within Fourth Generation Methodology to evaluate (SPECAL) Specialized Early Care of Alzheimer's, a dementia care service and approach.

Anne Marie Tunney and Assumpta Ryan discuss a study that used the experiences of women caring for survivors to assist service redesign

Aim  The aim of this study was to explore how members of a stroke carers’ support group perceived that services for stroke patients and their carers could be improved.

This resource is aimed at both care providers and carers focusing on the key messages from the dementia quality standard and explaining how each quality statement relates to each audience. It provides links to key resources, further information, and practical tools which are relative to carers and care providers as appropriate. Drawing on existing guidance, NICE quality standards describe the high priority areas for quality improvement using a set of specific, concise and measurable statements.

Reports on an evaluation of Care Direct, a service launched by the Department of Health piloted in six areas offering information and support to people over 60 and their carers principally through a telephone help-line service. A survey of 600 callers was carried out during 2002. The analysis focuses on the characteristics of users and callers experience of using the service. Concludes that the experience of the first year has been positive, with the service meeting its targets in terms of range and volume of activity, and achieving satisfaction with callers.