10-144-113 Me. Code R. § III-6

Current through 2024-51, December 18, 2024

Section 144-113-III-6 - Alzheimer's/Dementia and Other Specialty Unit Standards

6.1 Alzheimers'/Dementia Care Units. A facility or unit designated as an Alzheimers'/Dementia Care Unit shall comply with the following regulations and the facility must have received written designation from the Department.

6.2 Admission requirements .

6.2.1 At the time of admission to an Alzheimers'/Dementia unit, the resident's individual record must contain:

6.2.1.1 Documentation of the legal representative's authority for placement, including but not limited to, the order, instrument or other documentation upon which the legal representative or facility relies upon for authority, the name, address and telephone number of the individual(s) consenting to placement, and all other documentation required by State and Federal law for valid authority

6.2.1.2 Documentation of a physician's diagnosis of Alzheimers' disease or dementia within 30 days of admission to the unit.

6.3 Design standards. The unit shall be designed to accommodate residents with dementia, enhance their quality of life, and promote their safety.

6.3.1 Physical design. In addition to the physical plant standards required for the licensure, an Alzheimers'/dementia care unit shall have:

6.3.1.1 Adequate space for dining, group and individual activities and family visits;

6.3.1.2 For facilities licensed after May 29, 1998, secured outdoor space and walkways, which allow residents to ambulate, but prevent undetected egress;

6.3.1.3 High visual contrasts between floors and walls and doorways and walls in resident use areas. Other doors used as fire exits and access ways may be designed to minimize contrast to obscure or conceal areas the residents should not enter;

6.3.1.4 Non-reflective floors, walls and ceilings;

6.3.1.5 Adequate and even lighting which minimizes glare and shadows; and

6.3.1.6 A staff work area for charting and storage of resident records, and a communication system such as a telephone or two-way voice actuated call system.

6.3.2 Physical environment. The designated Alzheimers'/dementia care unit shall:

6.3.2.1 Provide freedom of movement for the residents between common areas and his/her room;

6.3.2.2 Provide assistive equipment that maximizes the independence of individual residents;

6.3.2.3 Label or inventory all resident's possessions;

6.3.2.4 Provide comfortable, non-institutional seating in the common use areas;

6.3.2.5 Encourage residents to decorate and furnish their rooms with personal items and furnishings, as appropriate;

6.3.2.6 Individually identify resident's rooms as appropriate; and

6.3.2.7 Only use a public address system in the unit (if one exists) for emergencies.

6.3.3 Physical Safety.

6.3.3.1 The designated Alzheimers'/dementia care unit shall have policies and procedures regarding residents who may wander. The procedures shall include actions to be taken in case a resident elopes.

6.3.3.2 If locking devices are used on doors that exit the unit, as approved by the building codes agency and the Office of the State Fire Marshal having jurisdiction over the facility, then the locking device shall be electronic and will automatically release when the following occurs:

6.3.3.2.1 Upon activation of the fire alarm or sprinkler system;

6.3.3.2.2 Power failure; or

6.3.3.2.3 Bypassing a key button/key pad located at exits for routine use by staff for service.

6.3.3.3 If the unit uses keypads to lock and unlock doors exiting from the unit, then directions for access to the unit shall be posted on the outside of the door.

6.3.3.4 The units shall not have entrance and exit doors that are closed with non-electric keyed locks, nor shall a door with a keyed lock be placed between a resident and the exit.

6.4 Therapeutic activities for Alzheimers'/Dementia Care Units. All facilities with Alzheimers'/Dementia Care Units shall offer the following types of individual or group activities at least weekly:

6.4.1 Gross motor activities (e.g., exercise, dancing, gardening, cooking, etc.);

6.4.2 Self-care activities (e.g., dressing, personal hygiene/grooming, etc.);

6.4.3 Social activities (e.g., games, music, reminiscing, etc.);

6.4.4 Crafts (e.g., decorations, pictures, etc.);

6.4.5 Sensory enhancement activities (e.g., auditory, visual, olfactory and tactile stimulations, etc.);

6.4.6 Outdoor activities (e.g., walking outdoors, field trips, etc.); and

6.4.7 Spiritual activities.

6.5 Pre-service training for Alzheimers'/Dementia Care Units. For pre-service training, all facilities with Alzheimers'/Dementia Care Units must provide a minimum of eight (8) hours classroom orientation and eight (8) hours of clinical orientation to all new employees assigned to the unit. The trainer(s) shall be qualified with experience and knowledge in the care of individuals with Alzheimers' disease and other dementias. In addition to the usual facility orientation, which shall cover such topics as resident rights, confidentiality, emergency procedures, infection control, facility philosophy related to Alzheimers' disease/dementia care, and wandering/egress control, the eight (8) hours of classroom orientation shall include the following topics:

6.5.1 A general overview of Alzheimers' Disease and related dementias;

6.5.2 Communication basics;

6.5.3 Creating a therapeutic environment;

6.5.4 Activity focused care;

6.5.5 Dealing with difficult behaviors; and

6.5.6 Family issues.

6.6 Specialty Units other than Alzheimers'/Dementia

6.6.1 Design standards. The unit shall be designed to accommodate residents who will be admitted to the unit.

6.6.2 Program standards: Program standards shall be in accordance with accepted industry standards.

6.7 Therapeutic activities. All facilities with specialty care units shall offer the following types of individual or group activities in accordance with the assessed needs of the residents:

6.7.1 Gross motor activities (e.g., exercise, dancing, gardening, cooking, etc.);

6.7.2 Self-care activities (e.g., dressing, personal hygiene/grooming, etc.);

6.7.3 Social activities (e.g., games, music, reminiscing, etc.);

6.7.4 Crafts (e.g., decorations, pictures, etc.);

6.7.5 Sensory enhancement activities (e.g., auditory, visual, olfactory and tactile stimulations, etc.);

6.7.6 Outdoor activities (e.g., walking outdoors, field trips, etc.); and

6.7.7 Spiritual activities.

6.8 Pre-service training for Specialty Care Units. For pre-service training, all facilities must provide a minimum of eight (8) hours classroom orientation and eight (8) hours of clinical orientation to all new employees assigned to the unit. The trainer(s) shall be qualified with experience and knowledge in the care of individuals specific to that specialty. In addition to the usual facility orientation, which shall cover such topics as resident rights, confidentiality, emergency procedures, infection control, facility philosophy related to care, the eight (8) hours of classroom orientation shall include the following topics:

6.8.1 A general overview of the related specialty;

6.8.2 Communication basics;

6.8.3 Creating a therapeutic environment;

6.8.4 Activity focused care;

6.8.5 Dealing with difficult medical issues and/or behaviors; and

6.8.6 Family issues.

10-144 C.M.R. ch. 113, § III-6