ALTERNATIVE SOLUTIONS
By Sandra Stimson ADC, CALA, CDP Executive Director,
Alternative Solutions in Long Term Care

ABOUT SANDRA

Sandra Stimson has experience as a
corporate consultant, Corporate Trainer
and National Speaker. Her experience is
in long term care, as Activity Director,
Director of Alzheimer's Units and
Assistant Administrator of a 550 bed long
term care county home.  She is
Co-founder of Pet Express Pet Therapy
Club, is a Life Replay Specialist.  
Sandra implements dementia units
nationwide.  Sandra has written several
books, Volunteer Management
Essentials for Long Term Care and Pet
Express Pet Therapy Program. Sandra
has been a facilitator for Alzheimer's
support groups and is the Awards Chair
for the NJ Association of Activity
Professionals.  Sandra is the Executive
Director of
National Council of Certified
Dementia Practitioners
http://www.nccdp.org  

Alternative Solutions in Long Term
Care offers resources for health care
professionals in many areas of dementia
care, care plans, Snoezelen products,
dementia activity calendars, adult day
care calendars, sensory calendars,
reminisce videos for dementia, activity
books, and dates to remember, party
supplies,
resources and links.
Each Norman Rockwell print is
paired with a national standards of
Resident Rights and is
illustrated by a picture depicting
the "Resident Right."

click here to purchase resident
rights prints
THE ACTIVITY DIRECTOR
for Activity Professionals
in Long Term Care Settings
admin@theactivitydirectorsoffice.com

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The Activity Director's Office
All Rights Reserved

Disclaimer
ACTIVITY DIRECTOR TODAY
Sandra Stimson
Take Precautions During Community Outings
With Your Dementia Residents
Sandra Stimson CALA, ADC, CDP, Executive Director

Dementia residents can attend facility trips as long as precautions have been taken. There
are some residents who would not benefit from attending community trips because they are
fearful once off the unit or when it is extremely difficult to bring a dementia resident back to
the unit. The staff should discuss as a team which residents would be appropriate and who
would benefit from a community trip. The most important aspect to consider is the safety of
the resident.

Some questions to ask when considering a resident for a community outing are:
    1. Would they enjoy the outing?
    2. Are they fearful when off the unit?
    3. If they have already taken a trip, did they enjoy the trip or were their concerns?
    4. Is it difficult to return the resident to the dementia unit?
    5. Is the resident violent?
    6. What safety precautions would you need to take when the resident is off the unit?
    7. If the resident is in a wheelchair, can they maneuver their wheel chair or do they
    need assistance?
    8. If the resident ambulates, do they need assistance?
    9. How much additional staff would you need if you took this resident off the unit?
    10. Does the resident have proper identification?
    11. Does the resident (if a wanderer) have GPS tracking system or Project Lifesaver?
    12. What type of setting are you taking the resident too? For example, apple orchard,
    diner, pet shop, etc.
    13. Is the resident on a special diet? Are adaptive devices used?
    14. Is the resident on special medications with time frames?

When ever there is a community outing, the Director of Nursing should insure that a nursing
assistant is accompanying the residents. At times, some communities have only taken an
activity staff member. Why take the chance of something happening? It only makes sense to
insure that there is an appropriate number of activity staff as well as a nursing assistant
attending the trips. Some assisted living communities do not utilize a bus driver, which
leaves only the activity staff to drive the bus and monitor the residents. This is a disaster
waiting to happen. There are safety concerns while on the bus, such as falls and many
concerns once they arrive at the destination. The biggest concern of course is someone
wandering away from the group.

The destination should be well thought out. An activity assistant once took 8 residents by
herself to an apple orchard and parked in a secluded location. Because of the density of the
apple orchard, she immediately lost a resident and did not have a cell phone to call for help.
Another facility took their residents to Statue of Liberty. Anyone who has ever been to the
Statue of Liberty will tell you how crowded it is. The resident ended up in New York City and
was missing for 24 hours. In both situations, the residents were found by law enforcement
and were unharmed. They were very lucky.

It is important to pick a destination that is contained, such as a small diner or a small pet
store. Some of the trips might be a drive through the park. Large department stores, county
fairs, etc may not be good venues for the dementia resident. Even if the residents are not
getting off the bus, you should have adequate staff on the bus to monitor the residents.
Once you arrive at your destination, never leave your group unattended and constantly do a
head count. If this is someone with a history of elopement, assign a specific staff member to
only monitor that specific resident. Be sure that everyone in your group has an ID bracelet
with their name and name of your community. Some facilities have the residents all wear
facility T Shirts with the name of their community on the shirt. Plan to have enough staff to
provide safe supervision.

When planning the trip, the destinations should be a short drive. Once there, allow about 45
minutes to an hour and than return. Anything longer than that is probably too tiring for the
dementia resident. They would enjoy the trip much more if it is a short duration.

Always leave with the receptionist and the nursing departments the names of the residents
and staff who are attending the trip, time of departure and time of return, name of location,
address and phone number. If you are contracting for transportation, include the name on
your trip form. Additionally, provide your cell phone number. Have the dietary department
provide drinks and snacks such as Orange Juice and Graham crackers. Always carry a cell
phone in case of an emergency. Should there be an emergency or an elopement,
immediately notify the facility administration staff and 911 if necessary. If it is an elopement
you should immediately call 911 for assistance. If the resident has Project Lifesaver, be sure
to notify the 911 operator.

Dementia residents will have an enjoyable and safe trip as long as safety precautions are
put into place and implemented.


(CDCM) -Certified Dementia Care Manager  
Dementia Unit Manager / Supervisor
Best Practice Recommendations

Purpose: To provide minimum standards and best practices for those holding management
positions and oversight for Dementia Units. Oversight includes at minimum, coordination,
implementation and development of existing and new Dementia Units, best practices and
policies.

Qualifications: The manager / supervisor of the dementia unit must be 21 years of age and
possess:

  • Completion of a comprehensive Alzheimer's’s and dementia education program by a
    “live” instructor which includes a minimum of 8 hours consisting of: Overview of
    dementia, Diagnosis, Prognosis, Treatment, Communication, Feelings, Depression,
    Repetitive Behaviors, Sun Downing, Paranoia, Hallucinations, Wandering, Hoarding,
    Aggressive Behaviors, Catastrophic Reactions, Intimacy, Sexuality, Pain Management,
    Bathing, Dressing, Toileting, Nutrition, Activities, Environment, Staff Support, Family
    Support, Diversity and Cultural Competence, Spiritual Care and End of Life Issues.
    Evidence of completion is a certificate from NCCDP approved trainer.
  • A Bachelors degree in therapeutic recreation, social work, psychology, gerontology,
    health care administration or related health care field. Or LPN and or RN.
  • Successful completion NCCDP approved CDCM training course which includes:
    Dementia unit best practices, policy and procedures and Alzheimer’s and dementia 8
    hour course.  
  • Certified as Certified Dementia Practitioner in good standing with the NCCDP and or
    Dementia certification from a nationally recognized organization. NCCDP reserves the
    right to deny any application.
  • Certified as a Certified Dementia Care Manager in good standing with the NCCDP.
  • Current certification, registration, or license in a health care profession and good
    standing with the governing body and/or approved graduate degree from an
    accredited college or university.
  • At minimum 3 years health care experience working directly with geriatric population.
  • At minimum 1 year health care experience in a management role.
  • Must meet all local health regulations, state and federal regulations where applicable.
  • 1 year experience providing training or in-services to health care staff.
  • Certified Dementia Care Manager Course

Upon completion of this course, the student will be certified as a Certified Dementia Care
Manager.

Course includes:
  • 8 hours Alzheimer’s and dementia education
  • Dementia Unit Best Practices
  • Dementia Unit Policy and Procedures
  • Professional Ethics
  • Customer Service
  • Family Support
  • Professional Development

Visit NCCDP at:  
http://www.nccdp.org/index.htm
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