It was exciting to read that at ALFA’s most recent national conference in May, setting standards for dementia care was identified as a critical issue for their organization. Some studies indicate that up to 60-70% of residents living in assisted living have memory changes such as MCI (mild cognitive impairment), Alzheimer’s disease, vascular dementia or some other type of dementia.
It’s a credit to ALFA that they are making standards of dementia care a priority for their assisted living members.
Providing compassionate and life-affirming care for people living with dementia is complex. The pervasive culture of “person-centeredness”, providing care that is individualized and respects the “whole” person, needs passionate leadership, adequate staff training and engagements that are stimulating and interactive. This type of care is not easy to deliver. ALFA’s focus on setting standards for dementia care will provide the “top down” support for dementia care operators to assess their programs and improve as needed.
Consumers, such as customers shopping for senior housing, may assume there are already standards in place for dementia care. Almost every assisted living sells itself as providing “memory care” for their residents. Unfortunately, not every Assisted Living community has done its “homework” and prepared a safe and life-affirming environment for their residents affected by dementia.
Each state has its own regulations defining which type of assisted living can provide care for people with dementia. There are not national standards. Most states have regulations that require some additional training, but it varies from 6 hours up to 40 hours of training. Some states require that there is nursing on-site or other states may only require a nurse available “on-call”, or no nurse at all. Most states don’t specify staff ratios for caring for those affected by dementia, but will write something vague like “staff must be adequate to provide for the health and safety of the resident” – interpretation is left to the dementia-care operator.
As consumers of dementia care services, it behooves us to ask questions. If you’re moving into a memory-care assisted living, what are their standards? Can they explain those standards to you and also explain how they operationalize them – how many hours of training does their staff receive? What is the ratio of direct care givers to the residents? How do they handle emotional outbursts (behavioral expressions) by residents? Do they have a medical director or other health care providers who visit the residents on-site? What is their system for handling a resident who becomes ill?
As customers of dementia care, we can help improve standards of care by asking questions of our assisted living operators and showing them that compassionate care is the standard we expect!