Long-Term Care Survey Alert

Sometimes even the best dementia care program wont make surveyors happy, especially if they arent up to speed on Alzheimers disease.

"Some surveyors are very savvy about Alzheimers disease and others get very concerned about things like placement of call lights," says Gail Schober, director of the Alzheimers program at Sherrill House in Boston. "Yes, you have to have call lights but usually a person with even moderate AD isnt going to be able to use a call light appropriately."

So your facility may have to educate surveyors in a "collegial way" about AD, your dementia care program and the clinical rationale for creative and flexible approaches that some surveyors may initially mistake as irresponsible, Schober advises. "You can help surveyors understand what people with AD can and cannot do at various stages of the disease, for example," Schober says.

You may have to explain why your staff changed a medication schedule to accommodate a particular residents behavioral pattern. Or that you are allowing a resident to forego wearing a sling for an arm cast, as an example, because it causes her extreme emotional distress to wear it. These "deviations" should, however, be on the care plan.