Change is coming. CMS has introduced multiple changes to nursing home regulations that will impact the industry, especially those facilities providing dementia care. Even though the comment period was extended, organizations need to take these potential changes seriously and begin to implement strategies and programs now. Doing so will not be quick or easy. It is clear that it will require an organizational approach with effective and consistent staff communication, thus organizations with high turnover will have the greatest difficulty.
I will not attempt to tackle all of the proposed initiatives, but two major areas of focus with new emphasis should not be a surprise to anyone in the industry; person-centered care and dementia care. For many years numerous advocacy groups, associations, and organizations as well as CMS have advocated for person-centered care and dementia training as a means to improving life for older adults with dementia in long-term care. Facilities should have already implemented much of what is going to be expected, not simply because it will be regulated but because much of what is proposed is actually “best practice.” Are we not an industry that is committed to offering the best quality of care and life to those we serve?
Memory care units and facilities have exploded, with no definition of what a memory care program actually is or should be. However, few would argue that an “authentic” or effective memory care program include well-trained staff, individualized care and programs. Staff in many facilities have not received appropriate education or training on the disease process, or techniques to enhance outcomes and quality of life. Not only is it lacking in nursing homes, but in assisted living as well.
And yet consumers reading brochures and websites often find language that imply that a facility’s memory care program provides “trained staff,” “individualized programs and activities,” etc. Unfortunately, all too often that is not what they experience.
An effective memory care/dementia program is beneficial to the residents, families and staff. Staff want to be trained to deliver the best care possible. Working with individuals with memory loss requires initial training as well as ongoing education and communication. It is an ever-changing disease process and dependent upon the knowledge and abilities of caregivers for a chance at any quality of life.
While you can read about Alzheimer’s disease and dementia forever, the clinical experience and knowledge gained with “hands-on” involvement is far superior. And the sharing of each caregiver’s strategies and experience enhances the success of their colleagues and the outcomes for residents.
Gathering and communicating information about each individual resident, their history, current status and effective strategies to promote a high quality of life simply generates better care, but in dementia care it is essential. Organizational processes and procedures for the admission and transition to long term care for the resident and family should be carefully planned as well as a system for family input, engagement and communication.
Prepare now. Ask yourself if you are prepared to develop handle internally or if you would be better served to seek external experts. A CEO recently told me that he saved years of work and a great deal of money. He wanted to develop a “best practice” memory care program and had decided that they would do so in-house with his own staff. After attending a national conference and listening to dementia care expert presenters discussing their memory programs, he realized that each program was created and evolved over 20 to 25 years of “hands-on experience.” He decided to hire an expert consultant confident that he had saved countless years of work as well as tens of thousands of dollars.
Regardless of new regulations, remember that true person-centered dementia care can make a difference in the life of a person, their family and staff. As an industry we owe it to those we serve.