California Assisted Living Facilities Must Take Extra Precautions When Caring For Residents With Dementia

Title 22 of the California Code of Regulations Section 87705 requires California assisted living facilities to take certain precautions when caring for residents with dementia to ensure that the health and safety of the resident are protected. In general, the regulation imposes certain precautionary measures and staff training requirements.

Staff Training For Dementia Care

22 CCR 87705(c)(3) requires assisted living facilities to provide on-the-job training for direct-care staff to ensure that staff has “knowledge about hydration, skincare, communication, therapeutic activities, behavioral challenges, the environment, and assisting with activities of daily living.” As residents with dementia may be unable to communicate their hydration or skincare needs, staff must be able to understand these needs without queuing by the resident. Likewise, dementia may manifest negative behaviors that prove challenging for untrained staff. 22 CCR 87705(c)(3) ensures that staff directly involved in caring for residents with dementia will receive training on these negative behaviors, including training on “recognizing symptoms that may create or aggravate dementia behaviors, including, but not limited to, dehydration, urinary tract infections, and problems with swallowing.” Quality assisted living facilities will have a nurse on staff who supervises resident care and can identify causal factors for aggravated dementia behaviors such as UTI’s (urinary tract infections) or swallowing impairments. Nevertheless, if a staff nurse with experience in dementia care is not available, direct care staff may be able to identify medicinal causes of negative behaviors as the regulation requires that they receive training on “recognizing the effects of medications commonly used to treat the symptoms of dementia.” Lastly, while not directly related to staff training, the regulation also requires assisted living facilities to have adequate staff to care for their dementia residents.

Dementia Precautions

Assisted living facilities who care for residents with dementia are required to take certain precautions. The regulation requires assisted living facilities to fence-off bodies of water to prevent drowning. For instance, ponds should be enclosed by a fence. Furthermore, certain dangerous items should be made inaccessible to prevent injury. For example, kitchen knives, matches, tools, and household cleaners should be kept in a place residents cannot access. In addition, outdoor areas used by residents for recreation should be enclosed by fences with self-latching gates to mitigate the risk of the resident wandering off the premises. In relation, assisted living facility staff, without violating the personal right of the resident to leave the premises, should attempt to redirect the resident with dementia before they leave the facility. However, following redirection, if the resident still desires to leave the facility they shall be permitted to do so with staff supervision, and facility staff shall ensure the resident’s continued safety once they leave the facility.