FTAG 248 is changing: Are you ready? “Activities:
The facility must provide for an ongoing program
of activities designed to meet, in accordance
with the comprehensive assessment, the interests
and the physical, mental and psychosocial well-being
of each resident.” If you are not familiar
with F248 and 249 and the interpretive guidelines,
you can purchase the book through American Health
Care Association located in Washington DC, Titled,
The Long Term Care Survey. Pay close attention
to the interpretive guidelines. You can also
purchase a video titled “surveying the
activity department” through Heaton Resources.
This is the training video for surveyors.
What this means in changes to come either in
the regulation or interpretive guidelines, is
that every single resident must have appropriate
programs to fit their needs through large or
small groups and one on one. Many facilities
are still using one calendar instead of multiple
calendars to fit the needs of the dementia clients
and the low functioning. If you have not completed
a population analysis and a calendar analysis,
we strongly advise that you purchase these forms
and make changes based on the findings from
theses analysis. You can purchase at www.activitytherapy.com
Observe your programs just as a state surveyor
would. Can every resident in that program participate.
Walk around your building. Make a list of every
resident who is not attending and determine
why and implement programs to fit their needs.
One big change that every facility will need
to address, is sensory rooms. All facilities
will need to have sensory rooms. It’s
not a state recommendation or a federal requirement.
But in an average building size of 230 clients,
you have at least 40 residents who can not participate
in the currently scheduled activity because
of their illness or cognition. Sensory rooms
are recommended for this segment of your population.
Many of these clients have been identified on
your quality indicator report as “little
or no activity.” A sensory room makes
sense as it can accommodate large groups who
need stimulation. The sensory room is not a
warehouse room. There should be ongoing stimulation
while the clients are in this room such as hand
massages. You should be documenting in their
care plans if they are attending the sensory
rooms. Prior to care plan meeting document their
participation in the activity notes or interdisciplinary
notes. If you don’t have space for a Sensory
room, try placing it against the back wall of
your dining room.
Sensory rooms can be used for dementia clients,
NPO programs, pain management, depression, end
stage hospice, just to name a few. It is also
an excellent room for families to spend time
with their loved ones who can no longer communicate.
Families who bring small children also enjoy
this room as it’s interactive and fun.
Staff should be encouraged to use these rooms
for stress relief as facilities are required
to provide stress programs for their staff.
We offer 150 sensory products, sensory room
policy and procedures, in-services and care
plans for sensory rooms at www.activitytherapy.com/store
Besides sensory rooms, you could also have
fish tanks, aviaries, fake fireplaces, pet therapy,
aroma therapy and pretty gardens to provide
stimulation for your low functioning clients.
Additionally, long term care facilities are
about 80% dementia. This clearly shows the need
for dementia activity programming. Your facility
may not have a dementia unit but that should
not stop you from beginning a dementia program.
If you need suggestions for activities, see
www.activitytherapy.com. We also have several
great books such as Wake Up and Activity Planning
Work Book both offer excellent ideas for activities.
Facilities will need to look at hiring more
staff for the recreation department in order
to accommodate the changes to come. The surveyors
will want to see more staff involvement, especially
by the CNA’s. One big citation that we
are seeing is for “lack of supervision
in the day rooms.” Either no one is supervising
the dementia or low functioning clients or the
day rooms are too crowded with only one activity
assistant in the room. This will no longer be
tolerated. This is due to the increase in accidents
and incidents in the day rooms that are left
unsupervised during the day or at night or over
crowded conditions and not enough supervision.
Many facilities are now offering programs 7
days and 7 nights a week. We recommend ordering
Surveyor Guidebook on Dementia, Evaluating Compliance
with Regulatory Requirements which can be ordered
through American Health Care Association.
According to the Alzheimer’s Care Guide,
July / August 2005 Issue www.care4-elders.com “An
early draft of the proposed new guidelines stressed
activities need to include those that are not
childish, are mentally stimulating, are relevant
to gender, are related to the resident’s
areas of previous work and interests, allow
for socializing, are conducted outdoors whenever
feasible, are related to residents hobbies,
are connected with the community groups and
involve outings outside the residence, provide
training in new areas of learning and more.
In addition to all that, they’ll dwell
considerably on making sure residents also have
activities that are specifically therapeutic
to their various individual medical situations
and problem areas. Plus they’ll emphasize
the types of equipment to be used in the various
therapeutic activities and in improving the
situation with residents who have impairments,
such as hearing and sight.” This would
include sensory rooms, pet therapy, aroma therapy,
dementia activities, out door gardens, daily
exercise and music programs, etc.
We strongly recommend this resource if you
do not currently receive the Alzheimer’s
Care Guide Activities Guide. You can order through
www.care4elders.com or call 319 563 0642.
Stay current with new trends and regulatory
changes... we recommend ElderCare
Activities Guide and Alzheimer's Care Guide for all activity
professionals.
