Failure to Provide Meaningful Activities for Dementia Residents on Weekends
Penalty
Summary
The deficiency involves the facility’s failure to provide meaningful, individualized activities to several residents with dementia, despite having a written activities policy and a posted activity calendar. Four residents with dementia were observed over the course of a weekend with no engagement in the scheduled activities. One resident with Alzheimer’s dementia, a former engineer, was observed sitting in a wheelchair in front of the TV, later asleep, and his son reported there were no ongoing activities on Saturdays or Sundays and that he wanted his father to be engaged. This resident’s activity care plan documented impaired cognitive function/dementia but contained no activity interventions. Another resident with dementia, anxiety, and mood disorders was observed wheeling herself around the activity and dining rooms, being repeatedly redirected by an LPN, and later sitting in a wheelchair facing the TV stating there was nothing to do; her activity care plan also documented impaired cognitive function/dementia but had no activity interventions. A third resident with Alzheimer’s dementia was observed asleep in a wheelchair in front of the TV and later awake and looking around with no ongoing activities, despite a care plan stating the resident was dependent on staff for leisure pursuits and that Life Enrichment would provide individual visits and monitor participation. A fourth resident with dementia was observed sitting in a recliner and later at an activity table just looking around, again with no activities occurring, and had no activity care plan in the record. The Memory Care Activity Calendar listed multiple structured activities throughout the day, including positive affirmation, 1:1 reminisce, short stories, games, music and movement, and sensory exploration, but none of these were provided. Nursing staff, including an LPN and several CNAs, reported there were no activities on weekends in the dementia unit, that they tried to talk with residents or sit them by the TV in between nursing tasks, and that they had their own duties such as toileting, transferring, and feeding. The Life Enrichment Director and the Director of Memory Wellness both acknowledged that residents in the dementia unit need activities for engagement and that there was no activity staff on weekends, even though the facility’s activities policy states that meaningful, ability-centered activities for residents with cognitive or memory diseases are to be continually available.
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