Failure to Address Dementia Care Needs for Resident with Persistent Wandering and Rummaging Behaviors
Penalty
Summary
The facility failed to adequately address the dementia care needs of a resident who exhibited persistent wandering and rummaging behaviors, including going through staff members' belongings at the nurse's station and attempting to take items from other residents and staff. The resident had a documented history of multiple neurocognitive and psychiatric diagnoses, including Wernicke's encephalopathy, alcohol-induced persisting amnestic disorder, alcohol dementia, schizoaffective disorder, mood disorder, and anxiety. Over time, the resident's cognitive status declined from intact to moderately impaired, as reflected in the Minimum Data Set (MDS) assessments, and the care plan was updated to include interventions such as distraction with snacks, structured activities, and redirection. Despite these interventions, nursing notes repeatedly documented incidents where the resident attempted to take food, beverages, and other items from staff and other residents, rummaged through drawers, and entered unauthorized areas such as the nurse's station and other residents' rooms. Staff responses primarily involved redirection, providing snacks, and educating the resident that the behavior was inappropriate. However, these interventions were not consistently effective, as the resident continued to display the same behaviors over an extended period, and staff adapted by removing their personal belongings from accessible areas rather than addressing the underlying behavioral issues. Interviews with staff confirmed that the resident's behaviors were ongoing and that the primary approach was redirection and provision of snacks. The facility's policy on dementia care required individualized care plans and specialized staff training, but the documentation and staff interviews indicated that the interventions in place did not sufficiently address the resident's persistent behaviors. The lack of effective, individualized interventions placed the resident at risk for decreased quality of life and potential accidents.