New Report Offers Starting Point for Improved Assisted Living Care

Alzheimer's Association
Tuesday, 29 April 2003

Calling for improved quality care and services for assisted living residents who have Alzheimer's disease or dementia, the Alzheimer's Association today endorsed a series of recommendations for state regulations that will improve the quality of care.

Testifying before the Senate Aging Committee, Stephen McConnell, vice president of the Alzheimer's Association said, "recent studies show that 40 to 60 percent of all assisted living residents have Alzheimer's disease or dementia. We are particularly concerned about facilities that serve people with Alzheimer's disease and dementia but do not have appropriate programs or staff to meet residents' needs."

At a hearing in 2001, the Aging Committee asked representatives of the assisted living industry and consumer advocacy groups to meet and see what consensus they could reach regarding model rules and guidelines for consumers. The 23 organizations involved in the effort became known as the Assisted Living Workgroup, and many of the report's more than 130 recommendations were approved by two-thirds of the members.

"We voted in favor of almost all the recommendations, whether they are specific to dementia or not, because we believe that, if implemented, they will improve quality of care for all assisted living residents," McConnell stated.

"The Workgroup's report is not a set of regulations to be adopted word for word by states," McConnell said. "It is valuable not only because of the recommendations that received approval of a two-thirds majority, but also because of the recommendations that did not receive a two-third vote and the supplemental positions that explain the array of opinions around many of the recommendations. To our knowledge, nothing like this has been available before."

McConnell summarized five recommendations for state regulations about care and services for assisted living residents with dementia which require:

• All staff be trained to recognize signs and symptoms of possible dementia in their residents.


• Care plans be adapted for residents with dementia to take account of their cognitive impairments.


• Direct care staff receive training about dementia care.


• Individualized activities be available that match residents' abilities and interests.


• Residents be protected from danger, especially residents with unsafe wandering behaviors.

"These recommendations would seem to make common sense. But, we are not aware of any state with regulations that include all these dementia-specific recommendations," said McConnell. "Some states have regulations that do include detailed provision for Alzheimer's and dementia care, but these regulations apply only to 'special care units,' and therefore miss what we think is a critical point: most assisted living residents with Alzheimer's disease and dementia are not in special care units."

"Each state is different; we do not think any state will adopt all the Assisted Living Workgroup's recommendations," McConnell stated. "We have already presented information about the report and the recommendations to public policy staff from our [Alzheimer's Association] chapters all across the country. We expect they will work with other groups in their communities-the state and local affiliates of the organizations that participated in the Assisted Living Workgroup-to advocate for changes in state law and regulations, using the recommendations as a starting point."

In consideration of the proposed recommendations by the Workgroup, the Alzheimer's Association was guided by five general principles:

• Care occurs in the interactions between providers and residents; good care-high quality care-requires a partnership.


• Assisted living residents, including residents with dementia, are diverse; their care needs differ, and a single, strictly prescribed set of services is not going to work for all of them.


• The preferences of individual residents are important; the assisted living facility is their home; some flexibility is necessary to accommodate individual preferences.


• There are essentials that must be available for all residents; state regulations should mandate these essentials.


• It is important to move forward with recommendations that will improve the existing situation, even if they are not perfect.

The largest private funder of Alzheimer research, the Association has committed $136 million toward research into the causes, treatment, prevention, and cure of Alzheimer's. You can reach the Alzheimer's Association at 800.272.3900

For more information, or to contact Alzheimer's Association, see their website at: www.alz.org