Current through 2024-38, September 18, 2024
6.1
Alzheimers'/Dementia Care
Units. A facility or unit designated as an Alzheimers'/Dementia Care
Unit shall comply with the following regulations and the facility must have
received written designation from the Department.
6.2
Admission requirements .
6.2.1 At the time of admission to an
Alzheimers'/Dementia unit, the resident'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
facility 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 Alzheimers' disease or dementia within 30 days of admission to the
unit.
6.3
Design standards. The unit shall be designed to accommodate
residents with dementia, enhance their quality of life, and promote their
safety.
6.3.1
Physical design.
In addition to the physical plant standards required for the licensure, an
Alzheimers'/dementia care unit shall have:
6.3.1.1 Adequate space for dining, group and
individual activities and family visits;
6.3.1.2 For facilities licensed after May 29,
1998, secured outdoor space and walkways, which allow residents to ambulate,
but prevent undetected egress;
6.3.1.3 High visual contrasts between floors
and walls and doorways and walls in resident use areas. Other doors used as
fire exits and access ways may be designed to minimize contrast to obscure or
conceal areas the residents 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 resident records, and a communication system such as a telephone or
two-way voice actuated call system.
6.3.2
Physical environment. The
designated Alzheimers'/dementia care unit shall:
6.3.2.1 Provide freedom of movement for the
residents between common areas and his/her room;
6.3.2.2 Provide assistive equipment that
maximizes the independence of individual residents;
6.3.2.3 Label or inventory all resident's
possessions;
6.3.2.4 Provide
comfortable, non-institutional seating in the common use areas;
6.3.2.5 Encourage residents to decorate and
furnish their rooms with personal items and furnishings, as
appropriate;
6.3.2.6 Individually
identify resident's rooms 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 Alzheimers'/dementia
care unit shall have policies and procedures regarding residents who may
wander. The procedures shall include actions to be taken in case a resident
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 facility,
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 resident and the exit.
6.4
Therapeutic activities
for Alzheimers'/Dementia Care Units. All facilities with
Alzheimers'/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 Alzheimers'/Dementia Care Units. For pre-service training, all
facilities with Alzheimers'/Dementia Care Units must provide a minimum of eight
(8) hours 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 Alzheimers' disease
and other dementias. In addition to the usual facility orientation, which shall
cover such topics as resident rights, confidentiality, emergency procedures,
infection control, facility philosophy related to Alzheimers' 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 Alzheimers'
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.
6.6
Specialty Units other than Alzheimers'/Dementia
6.6.1
Design standards. The
unit shall be designed to accommodate residents who will be admitted to the
unit.
6.6.2
Program
standards: Program standards shall be in accordance with accepted
industry standards.
6.7
Therapeutic activities. All facilities with specialty care units
shall offer the following types of individual or group activities in accordance
with the assessed needs of the residents:
6.7.1 Gross motor activities (e.g., exercise,
dancing, gardening, cooking, etc.);
6.7.2 Self-care activities (e.g., dressing,
personal hygiene/grooming, etc.);
6.7.3 Social activities (e.g., games, music,
reminiscing, etc.);
6.7.4 Crafts
(e.g., decorations, pictures, etc.);
6.7.5 Sensory enhancement activities (e.g.,
auditory, visual, olfactory and tactile stimulations, etc.);
6.7.6 Outdoor activities (e.g., walking
outdoors, field trips, etc.); and
6.7.7 Spiritual activities.
6.8
Pre-service training
for Specialty Care Units. For pre-service training, all facilities must
provide a minimum of eight (8) hours 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 specific to that specialty. In addition to the usual facility
orientation, which shall cover such topics as resident rights, confidentiality,
emergency procedures, infection control, facility philosophy related to care,
the eight (8) hours of classroom orientation shall include the following
topics:
6.8.1 A general overview of the
related specialty;
6.8.2
Communication basics;
6.8.3
Creating a therapeutic environment;
6.8.4 Activity focused care;
6.8.5 Dealing with difficult medical issues
and/or behaviors; and
6.8.6 Family
issues.
