6.1 Alzheimers’/Dementia Care Units. A building or unit may be designated as an Alzheimers’/Dementia Care Unit if the following regulations are met and the assisted living program has received written designation from the Department.
6.2 Admission requirements.
6.2.1 At the time of admission to an Alzheimer’s/Dementia unit, the consumer’s individual record must contain:
6.2.1.1 Documentation of the legal representative’s authority for placement, including but not limited to, the order, instrument or other documentation upon which the legal representative or assisted living program relies upon for authority, the name, address and telephone number of the individual(s) consenting to placement, and all other documentation required by State and Federal law for valid authority.
6.2.1.2 Documentation of a physician’s diagnosis of Alzheimer’s disease or dementia within 30 days of admission to the unit.
6.3 Design standards. The unit shall be designed to accommodate consumers with dementia, enhance their quality of life, and promote their safety.
6.3.1 Physical design. In addition to any physical plant standards required for the licensure, an Alzheimer’s/dementia care unit shall have;
6.3.1.1 Adequate space for dining, group and individual activities and family visits;
6.3.1.2 Secured outdoor space and walkways, which allow consumers to ambulate but prevent undetected egress;
6.3.1.3 High visual contrasts between floors and walls and doorways and walls in consumer use areas. Other doors used as fire exits and access ways may be designed to minimize contrast to obscure or conceal areas the consumer should not enter;
6.3.1.4 Non-reflective floors, walls and ceilings;
6.3.1.5 Adequate and even lighting which minimizes glare and shadows; and
6.3.1.6 A staff work area for charting and storage of consumer records, and a communication system such as a telephone or two-way voice actuated call system.
6.3.2 Physical environment. The designated Alzheimer’s/dementia care unit shall:
6.3.2.1 Provide freedom of movement for the consumers between common areas and his/her room;
6.3.2.2 Provide assistive equipment that maximizes the independence of individual consumers;
6.3.2.3 Label or inventory all consumer possessions;
6.3.2.4 Provide comfortable, non-institutional seating in the common use areas;
6.3.2.5 Encourage consumers to decorate and furnish their units with personal items and furnishings, as appropriate;
6.3.2.6 Individually identify consumer’s units as appropriate; and
6.3.2.7 Only use a public address system in the unit (if one exists) for emergencies.
6.3.3 Physical Safety.
6.3.3.1 The designated Alzheimer’s/dementia care unit shall have policies and procedures regarding consumers who may wander. The procedures shall include actions to be taken in case a consumer elopes.
6.3.3.2 If locking devices are used on doors that exit the unit, as approved by the building codes agency and the Office of the State Fire Marshal having jurisdiction over the assisted living program, then the locking device shall be electronic and will automatically release when the following occurs:
6.3.3.2.1 Upon activation of the fire alarm or sprinkler system;
6.3.3.2.2 Power failure; or
6.3.3.2.3 Bypassing a key button/key pad located at exits for routine use by staff for service.
6.3.3.3 If the unit uses keypads to lock and unlock doors exiting from the unit, then directions for access to the unit shall be posted on the outside of the door.
6.3.3.4 The units shall not have entrance and exit doors that are closed with non-electric keyed locks, nor shall a door with a keyed lock be placed between a consumer and the exit.
6.4 Therapeutic activities for Alzheimer’s/Dementia Care Units. All facilities with Alzheimer’s/Dementia Care Units shall offer the following types of individual or group activities at least weekly:
6.4.1 Gross motor activities (e.g., exercise, dancing, gardening, cooking, etc.);
6.4.2 Self-care activities (e.g., dressing, personal hygiene/grooming, etc.);
6.4.3 Social activities (e.g., games, music, reminiscing, etc.);
6.4.4 Crafts (e.g., decorations, pictures, etc.);
6.4.5 Sensory enhancement activities (e.g., auditory, visual, olfactory and tactile stimulations, etc.);
6.4.6 Outdoor activities (e.g., walking outdoors, field trips, etc.); and
6.4.7 Spiritual activities.
6.5 Pre-service training for Alzheimer’s/Dementia Care Units. For pre-service training, all facilities with Alzheimer’s/Dementia Care Units must provide a minimum of eight (8) hours of classroom orientation and eight (8) hours of clinical orientation to all new employees assigned to the unit. The trainer(s) shall be qualified with experience and knowledge in the care of individuals with Alzheimer’s disease and other dementias. In addition to the usual assisted living program orientation, which shall cover such topics as consumer rights, confidentiality, emergency procedures, infection control, assisted living program philosophy related to Alzheimer’s Disease/dementia care, and wandering/egress control, the eight (8) hours of classroom orientation shall include the following topics:
6.5.1 A general overview of Alzheimer’s Disease and related dementias;
6.5.2 Communication basics;
6.5.3 Creating a therapeutic environment;
6.5.4 Activity focused care;
6.5.5 Dealing with difficult behaviors; and
6.5.6 Family issues.