Alzheimer’s and dementia care in the residential care setting
The goal of a specialized community for Alzheimer’s and other dementia-related diseases is to provide those people with a safe and secure area for them to thrive in midst of their disease process. While there may be many similarities to typical ALF communities these areas are designed to meet the unique physical and mental attributes of disease. The dementia care community shall be inclusive of all residents with dementia related diseases and give them the opportunity to have a fruitful remainder of life. See the following regulation provided by the Nevada Department of Health and Human Services to determine if you are in compliance with your dementia care community:
NAC 449.2754 Residential facility which provides care to persons with Alzheimer’s disease: Application for endorsement; general requirements. (NRS 449.0302)
1. A residential facility which offers or provides care for a resident with Alzheimer’s disease or related dementia must obtain an endorsement on its license authorizing it to operate as a residential facility which provides care to persons with Alzheimer’s disease. The Division may deny an application for an endorsement or suspend or revoke an existing endorsement based upon the grounds set forth in NAC 449.191 or 449.1915.
2. If a residential facility is authorized to operate as a residential facility which provides care to persons with Alzheimer’s disease and as another type of facility, the entire facility must comply with the requirements of this section or the residents who suffer from Alzheimer’s disease or other related dementia must be located in a separate portion of the facility that complies with the provisions of this section.
3. A residential facility which provides care to persons with Alzheimer’s disease may admit or retain a resident who requires confinement in locked quarters.
4. A residential facility which provides care to persons with Alzheimer’s disease must be administered by a person who:
(a) Has not less than 3 years of experience in caring for residents with Alzheimer’s disease or related dementia in a licensed facility; or
(b) Has a combination of education and training that the Bureau determines is equivalent to the experience required pursuant to paragraph (a).
5. The administrator of such a facility shall prescribe and maintain on the premises of the facility a written statement which includes:
(a) The facility’s policies and procedures for providing care to its residents;
(b) Evidence that the facility has established interaction groups within the facility which consist of not more than six residents for each caregiver during those hours when the residents are awake;
(c) A description of:
(1) The basic services provided for the needs of residents who suffer from dementia;
(2) The activities developed for the residents by the members of the staff of the facility;
(3) The manner in which the behavioral problems will be managed;
(4) The manner in which the medication for residents will be managed;
(5) The activities that will be developed by the members of the staff of the facility to encourage the involvement of family members in the lives of the residents; and
(6) The steps the members of the staff of the facility will take to:
(I) Prevent residents from wandering from the facility; and
(II) Respond when a resident wanders from the facility; and
(d) The criteria for admission to and discharge and transfer from the facility.
6. The written statement required pursuant to subsection 5 must be available for review by members of the staff of the facility, visitors to the facility and the Bureau.
7. The administrator shall ensure that the facility complies with the provisions of the statement required pursuant to subsection 5.
8. The members of the staff of the facility shall develop a program of activities that promotes the mental and physical enhancement of the residents. The following activities must be conducted at least weekly:
(a) Activities to enhance the gross motor skills of the residents;
(b) Social activities;
(c) Activities to enhance the sensory abilities of the residents; and
(d) Outdoor activities.
(Added to NAC by Bd. of Health by R003-97, eff. 10-30-97; A by R073-03, 1-22-2004; R119-10, 1-13-2011)
NAC 449.2756 Residential facility which provides care to persons with Alzheimer’s disease: Standards for safety; personnel required; training for employees. (NRS 449.0302)
1. The administrator of a residential facility which provides care to persons with Alzheimer’s disease shall ensure that:
(a) Swimming pools and other bodies of water are fenced or protected by other acceptable means.
(b) Operational alarms, buzzers, horns, or other audible devices which are activated when a door is opened are installed on all doors that may be used to exit the facility.
(c) At least one member of the staff is awake and on duty at the facility at all times.
(d) Each employee of the facility who has direct contact with and provides care to residents with any form of dementia, including, without limitation, dementia caused by Alzheimer’s disease, successfully completes the training and continuing education required pursuant to NAC 449.2768.
(e) Knives, matches, firearms, tools and other items that could constitute a danger to the residents of the facility are inaccessible to the residents.
(f) The facility has an area outside the facility or a yard adjacent to the facility that:
(1) May be used by the residents for outdoor activities;
(2) Has at least 40 square feet of space for each resident in the facility;
(3) Is fenced; and
(4) Is maintained in a manner that does not jeopardize the safety of the residents.
Ê All gates leading from the secured, fenced area or yard to an unsecured open area or yard must be locked and keys for gates must be readily available to the members of the staff of the facility at all times.
(g) All toxic substances are not accessible to the residents of the facility.
2. The training required pursuant to NAC 449.2768 may be used to satisfy the requirement of paragraph (f) of subsection 1 of NAC 449.196 for the year in which the training is received.
Top Takeaways:
- (d) Each employee of the facility who has direct contact with and provides care to residents with any form of dementia, including, without limitation, dementia caused by Alzheimer’s disease, successfully completes the training and continuing education required pursuant to NAC 449.2768.
Operating a memory care community is one of the most difficult yet rewarding things to do related to resident care. The residents within this community typically have behaviors related to dementia such as, wandering, memory loss, incontinence, incoherent speech, loss of motor function and many other symptoms. These people need specialized care by staff trained specifically with how to assist their needs.
- The members of the staff of the facility shall develop a program of activities that promotes the mental and physical enhancement of the residents. The following activities must be conducted at least weekly:
The memory care community should not just be an area to hold residents suffering from a terrible illness. This unity shall be a community in itself with dignified meaning for residents who need specialized care. You should include services based upon each individual resident’s needs as well as having fruitful programming of activities.