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重点内容:失智症

来自 Title 22 第6分部第8章「第12条:失智症」的 6 条重点内容中文说明。如需可搜索、可收藏的版本,请使用互动学习指南

失智症照护:适用范围与员工培训要求
87705 p. 182
本条款专门适用于确诊患有失智症的住户——轻度认知障碍(MCI)不属于本条款所指的失智症。

作为87208(运营计划)所要求培训的一部分,员工须接受以下方面的培训:失智症照护的一般知识(补水、营养、皮肤护理、沟通、治疗性活动、行为挑战、环境、协助日常生活活动);识别可能引发或加重行为表现的症状(如脱水、尿路感染、吞咽问题);以及识别常用于减轻行为表现的药物的作用及影响。
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法规原文(英文)

(a) This section applies to the care of residents diagnosed with dementia. Mild cognitive impairment, as defined in Section 87101, Definitions, is not considered to be dementia.Part 4, Page 182
(b) Licensees shall be responsible for the following: (1) Ensuring staff receive the following training as part of the training requirements specified in Section 87208 Plan of Operation: (A) Dementia care, including, but not limited to, knowledge about hydration, nutrition, skin care, communication, therapeutic activities, behavioral challenges, the environment, and assisting with activities of daily living; (B) Recognizing symptoms that may create or aggravate behavioral expression, as defined in Section 87101, Definitions, including, but not limited to, dehydration, urinary tract infections, and problems with swallowing; and (C) Recognizing the effects of medications commonly used to reduce behavioral expression.Part 4, Page 182
夜间监督、追踪装置、出口监测与延迟出口
87705 p. 183
住户人数少于16人的设施中,如果某位失智症住户经评估、重新评估或观察被判定需要夜间清醒监督,设施须在标准87415夜间监督要求之外,额外配备至少一名夜间清醒在岗的员工。

在取得住户(或其监护人)事先书面同意的前提下,只要不违反其个人权利(87468.1),许可证持有人可为安全起见使用出口警报及位置追踪装置。设施还须配备声音装置或其他员工提醒机制,以监测有走失风险住户可进出的外部门及围栏出入口。

如果设施使用延迟出口装置,须做到:在确定安装日期后立即通知许可机构、取得涵盖该装置的消防许可、在有走失风险的住户试图离开时安排员工尝试进行引导(但不得违反其权利),并在住户经引导后仍坚持要离开时,允许其在员工监督下离开。
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法规原文(英文)

(2) For facilities with fewer than 16 residents, ensuring there is at least one night staff person awake and on duty if any resident with dementia is determined through a pre-admission appraisal, reappraisal, or observation, to require awake night supervision. This requirement is in addition to requirements specified in Section 87415, Night Supervision.Part 4, Page 183
(c) With the prior written approval of the resident or conservator and provided such devices do not violate the resident's rights as specified in Section 87468.1 Personal Rights of Residents in All Facilities, the licensee may use egress alert and location tracking devices as needed to ensure resident safety. (d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions.Part 4, Page 183
(e) Licensees that use delayed egress devices on exterior doors and perimeter fence gates shall meet the following initial and continuing requirements: (1) The licensee shall notify the licensing agency immediately after determining the date that the device will be installed. (2) The licensee shall ensure that the fire clearance includes approval of delayed egress devices. (3) Facility staff shall attempt to redirect a resident at risk for elopement who may be attempting to leave the facility without violating Section 87468.1, Personal Rights of Residents in All Facilities. (4) Residents who continue to indicate a desire to leave the facility following redirection shall be permitted to do so with staff supervision.Part 4, Page 183
走失安全、报告与门锁要求
87705 p. 184
如果住户走出设施范围,员工须在不违反其个人权利(87468.1/87468.2)的前提下确保其安全。每一起走失事件都须报告给该住户的代表(须在获悉后立即报告,并依87211另行提交书面后续报告)以及许可机构的值班官员(不得晚于事件发生后的下一个工作日)。延迟出口装置绝不能替代足以真正监督住户所需的充足受训员工。

如果设施对外部门或围栏出入口上锁,须做到:通知许可机构该意向、取得涵盖门锁的消防许可批准(且每班须有员工能够开锁),并在不违反其权利的前提下仍尝试引导有走失风险的住户。
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法规原文(英文)

(5) Facility staff shall ensure the continued safety of residents if they wander away from the facility without violating Sections 87468.1, Personal Rights of Residents in All Facilities and Section 87468.2, Additional Personal Rights of Residents in Privately Operated Facilities. (6) For each incident of elopement, as defined in Section 87101, Definitions, the licensee shall report the incident to: (A) The resident's representative, if applicable, immediately upon becoming aware of the incident... (B) The licensing agency Officer of the Day, by telephone, e-mail, fax, or hand-delivery no later than the next working day following the incident. (7) Delayed egress devices shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents, including staff needed to escort residents who need supervision to leave the facility.Part 4, Page 184
(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (1) Licensees shall notify the licensing agency of their intention to lock exterior doors and/or perimeter fence gates. (2) The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates and that facility staff on all shifts have access to, and know how to use, equipment needed to unlock exterior doors or perimeter fence gates. (3) Facility staff shall attempt to redirect a resident at risk for elopement who may be attempting to leave the facility without violating Section 87468.1, Personal Rights of Residents in All Facilities.Part 4, Page 184
游走空间与人员配置不可用门锁替代
87705 p. 185
设施须提供充足的室内及室外空间,供失智症住户自由且安全地游走。而且和延迟出口装置一样,上锁的外部门或围栏也绝不能替代足以满足所有住户照护与监督需求的充足受训员工。
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法规原文(英文)

(5) Interior and exterior space shall be available on the facility premises to permit residents with dementia to wander freely and safely. (6) Locked exterior doors or perimeter fences with locked gates shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents.Part 4, Page 185
失智症特别照护广告:活动项目说明
87706 p. 186
如果许可证持有人对外宣传/推广失智症特别照护、项目安排或环境,须在其运营计划中提供更详尽的说明——其中包括针对失智症住户的活动项目说明,涵盖所提供的活动类型(认知/脑力刺激、体能活动、回忆疗法活动,依87219规定)。
查看 Title 22 法规原文

法规原文(英文)

(a) In addition to the requirements in Section 87705, Care of Persons with Dementia, licensees who advertise, promote, or otherwise hold themselves out as providing special care, programming, and/or environments for residents with dementia or related disorders shall meet the following requirements:Part 4, Page 186
(D) Activity program for residents with dementia. 1. Types of activities include, but are not limited to, activities that support cognitive/mental stimulation, physical activities and reminiscence activities, as specified in Section 87219, Planned Activities.Part 4, Page 186
停止失智症特别照护广告
87706 p. 188
如果许可证持有人停止宣传/推广失智症特别照护,须在停止至少30个日历日之前,通知许可机构、住户,以及(视情况而定)住户代表。在通知中所载明的日期,须停止一切提及失智症特别照护的广告(杂志、报纸、名录、网络、广播/电视等),并从推广材料、入住协议及运营计划中删除所有涉及失智症特别照护的书面表述。
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法规原文(英文)

(b) The licensee who discontinues advertising, promoting, or otherwise holding themselves out as providing special care, programming, and/or environments for residents with dementia shall: (1) Provide written notification to the licensing agency, residents and, as applicable, the residents' representative, as defined in Section 87101, Definitions, at least 30 calendar days prior to discontinuing advertising or promoting dementia special care, programming, and/or environments.Part 4, Page 188
(2) On the date specified in the notification, cease all advertisements, publications, and/or announcements that pertain to dementia special care including, but not limited to, those in magazines, newspapers, consumer reports, professional or service directories, Internet, radio and/or television commercials. (3) On the date specified in the notification, remove all written references that indicate that the licensee provides dementia special care, programming, and/or environments from all promotional material, advertisements, and/or printed material, including admission agreements and the plan of operation.Part 4, Page 188