Failure to Provide Diversional Interventions for Resident with Dementia
Penalty
Summary
A deficiency was identified when a resident diagnosed with dementia did not receive appropriate treatment and services to maintain their highest practicable physical, mental, and psychosocial well-being. The resident, who was severely cognitively impaired and had a history of wandering, pacing, and vocalizing confusion, was observed repeatedly pacing the hallways and expressing uncertainty about what to do. Despite a care plan that included interventions such as encouraging participation in meaningful activities, establishing routines, and providing diversional activities based on the resident's interests, staff failed to implement these interventions during multiple observed instances. During several observations, staff members directed the resident to sit in a hallway chair but did not offer any diversional activities or engage the resident in activities aligned with their documented interests, such as games, arts and crafts, exercise, music, or conversation. Each time the resident was instructed to sit, staff walked away, and the resident resumed pacing and verbalizing confusion. The resident was also observed to become increasingly distressed, rubbing their face and expressing fear or frustration when interacting with other residents. Interviews with staff confirmed that the resident required redirection and engagement in diversional activities, and that simply instructing the resident to sit was not effective. Staff acknowledged that the resident had demonstrated interest in certain activities, such as folding towels and word searches, but these were not offered during the observed periods. The lack of implementation of the care plan interventions and failure to provide appropriate diversional activities contributed to the deficiency.