Failure to Provide Individualized Dementia Care and Non-Pharmacological Interventions
Penalty
Summary
The facility failed to provide appropriate treatment and services to residents diagnosed with dementia, as evidenced by the care of two residents. One resident with diagnoses including neurocognitive disorder with Lewy bodies, Alzheimer's disease, anxiety, major depressive disorder, and a history of falls, was observed to be resistive to care. Despite a care plan instructing staff to use a warm, safe, and inviting approach, emphasizing dignity and patience, staff were observed physically pushing the resident towards the bathroom when he was unwilling to walk, rather than allowing time or using alternative non-pharmacological interventions as outlined in the care plan. Interviews with staff indicated inconsistent application of the care plan, with some staff offering snacks or dancing to encourage movement, while others resorted to physical guidance. Another resident with dementia, anxiety, and restlessness was also observed to be resistive to care, repeatedly attempting to stand and walk. The care plan directed staff to provide choices and use individualized, non-pharmacological approaches, but staff were seen physically guiding the resident back into a chair and telling her to sit down, rather than involving her in activities or walking with her as recommended. The facility's own dementia care policy requires individualized, non-pharmacological interventions to enhance well-being, but observations and interviews revealed that staff did not consistently follow these approaches for residents displaying dementia-related behaviors.