Registered Nurses' Association of Ontario

Guiding Principles and Assumptions

The following general principles inform the recommendations in this Guideline:

  • Each older adult is a distinctly unique human being with his/her own life experiences, strengths, preferences, cultural practices, values, and beliefs.
  • All older adults deserve equal access to high-quality care that is based on the best available evidence and is provided by knowledgeable, skilled, and compassionate health-care providers.
  • Older adults with delirium, dementia, and/or depression deserve to be treated with dignity by health-care providers and to take part in caring human interactions.
  • The health-care provider’s attitudes, behaviours, and communication style during interactions with older adults, and the language used to describe symptoms or behaviours related to delirium, dementia, and/or depression, are powerful; as such, ongoing education and reflective practiceG in relation to these topics is important.
  • Person- and family-centred care is essential to the care of older adults with delirium, dementia, and/or depression.
  • A recovery perspective—and an approach to care that promotes well-being, the reduction of symptoms, and/or the accommodation of behaviours—is beneficial to older adults, especially those with long-term conditions.
  • Quality of life for older adults with delirium, dementia, and/or depression is best optimized according to what the individual person values. Quality of life is subjective, as expressed by the person: the person determines what quality of life means for him/her.


The following assumptions underlie the recommendations in this Guideline and their application in practice:

  • “Family” is whomever the person considers to be family. Family members are often central to the lives of older adults and may be active partners in care.
  • Health-care providers value and engage family, recognizing that some people do not have family, that others may not want or need their family to be involved, and that family members are not always willing or able to help.
  • Health-care providers communicate assessments, care plans, interventions, and evaluations of care to other members of the health-care team, to families/care partners, and across care settings (as appropriate) through verbal communication and formal documentation processes.
  • Health-care providers practice within their scope of knowledge and abilities, and adhere to legal and ethical principles.
Older Adults
Delirium, Dementia, and Depression in Older Adults: Assessment and Care
Background Information