As the instances of dementia increase in California’s older population, so too will the need for high-quality dementia care. Assisted Living, Memory Care, and Continuing Care Retirement Communities can provide a home-like environment that promotes dignity and respect with highly trained staff members knowledgeable about the condition.
Dementia Care Regulations
In order to accept or retain residents diagnosed with Alzheimer’s disease or other dementias, RCFEs must meet additional regulatory requirements (Section 87705). CCLD imposes additional requirements in areas including staffing, documentation, and physical plant, in order for a community to accept or retain residents diagnosed with dementia. In 2016, dementia care training hours were increased and the requirement that all RCFE caregivers receive dementia training was applied. For more information, visit the Staff Training page.
In 2018, DSS released PIN 18-04-ASC to acknowledge that exceptions to the dementia regulations are an option as a way of supporting providers, families, and residents in avoiding unnecessary evictions.
In addition to these operation and care requirements, a separate section (Sections 87706 and 87707) of the regulations addresses advertising requirements for providers who advertise that they offer dementia care.
“Sundowning” is a condition in which residents with Alzheimer’s disease or other forms of dementia experience confusion, disorientation, and increasing levels of agitation coinciding with the onset of late afternoon and early evening.
In 2003, AB 528 (Mullin) was signed into law to encourage training on sundowning and the inclusion of information on specific activities for those who experience sundowning. While training on sundowning is not a requirement, the legislature deemed it an issue significant enough to acknowledge in a statute as a way to promote best practices.
For more information, including causes and coping strategies, visit the Alzheimer’s Association’s webpage on sundowning.
Mild Cognitive Impairment
Mild Cognitive Impairment (MCI) is a state in which at least one cognitive function is impaired to an extent that is greater than would be anticipated in the normal aging process. By definition, MCI is not dementia. The distinction between MCI and dementia is significant as it is the basis for determining who may reside in a particular RCFE.
Resources & Best Practices
Toolkit for Reducing Antipsychotic Use (Members Only)
Download this toolkit to track the number of residents with dementia that have orders for antipsychotic medications and ways to promote non-pharmacological interventions.
Mild Cognitive Impairment vs. Dementia in Assisted Living
Developed jointly with the Alzheimer’s Association, this brochure clearly defines mild cognitive impairment, dementia, and their distinctions. Available in packages of 50.
CALA News & Views Spring 2014: Mindful Memory Care
Articles on person-centered memory care activities, surrogate decision-makers, Alzheimer’s diagnosis, caregiving costs, and the National Plan to Address Alzheimer’s
CALA News & Views Fall 2011: Brain Health and Memory Care Perspectives
Articles on memory care design, caring for residents with dementia in general Assisted Living, dementia-focused training, challenging behaviors, and brain health
The Alzheimer’s Association’s Dementia Care Practice Recommendations, 2018
The fundamentals for person-centered care for individuals with dementia, including assessment and care planning, nonpharmacological practices, and care transitions.
The Alzheimer’s Association provides information regarding Alzheimer’s disease and dementia care. Access the list of California-based offices for local resources and support groups.
California Alzheimer’s Disease and Related Disorders Advisory Committee
In 1998, the California Health and Human Services Agency established this committee to advise the administration and legislature on issues regarding Alzheimer’s disease and related disorders.