Policies to Protect Persons With Dementia in Assisted Living
Policies to Protect Persons With Dementia in Assisted Living
Arguably, such an examination is required by federal law. In passing the Americans with Disabilities Act (ADA) in 1990 (42U.S.C.A. § 12102), the U.S. Congress assured equal protections guaranteed under the Fourteenth Amendment were extended to all persons with disabilities including those with degenerative neurological conditions (Rempfer, 1997; 42U.S.C.A. § 12101). Through the ADA, the federal government specifically requires businesses and nonprofit service providers including AL facilities, day care centers, hotels, and recreational facilities to comply with basic requirements that prohibit unequal treatment of "protected classes" such as persons with dementia (42U.S.C.A. § 12182). AL also has been included as a place of service subject to the Fair Housing Act (FHA), and for nearly 10 years, AL has been required to provide safe and accessible care settings for their residents (National Senior Citizens Law Center, 2005; U.S. Securities and Exchange Commission [SEC], 2006).
The need to extend equal protection to persons with dementia in AL becomes particularly compelling as intellectual functions deteriorate to the point when individuals can no longer engage in reliable decision-making needed to self-direct care in the manner AL promotes as a philosophy (Alzheimer's Association, 2009; Bynum, 2014). Persons with dementia should be protected from exploitation which may occur while executing a routine contract renewal featuring complex fee structures. Residents with dementia should be protected from neglect, abuse, and harm, especially as the capacity for self-care diminishes and responsibilities for an individual's well-being increasingly are assumed by DCWs. Environments should be safe and free of hazards that may not be known or recognized by persons with dementia. Staff should be sufficient in number and adequately trained as to provide programs and services that facilitate an individual's well-being. While ADA requirements are well-specified in some instances, such as the accommodations hotels must make for physically disabled guests (U.S. Department of Justice, Civil Rights Division, 2014), the systematic application of these requirements for AL residents with dementia appears lacking, despite the prevalence of dementia in AL.
The Need for Government Oversight of AL
Arguably, such an examination is required by federal law. In passing the Americans with Disabilities Act (ADA) in 1990 (42U.S.C.A. § 12102), the U.S. Congress assured equal protections guaranteed under the Fourteenth Amendment were extended to all persons with disabilities including those with degenerative neurological conditions (Rempfer, 1997; 42U.S.C.A. § 12101). Through the ADA, the federal government specifically requires businesses and nonprofit service providers including AL facilities, day care centers, hotels, and recreational facilities to comply with basic requirements that prohibit unequal treatment of "protected classes" such as persons with dementia (42U.S.C.A. § 12182). AL also has been included as a place of service subject to the Fair Housing Act (FHA), and for nearly 10 years, AL has been required to provide safe and accessible care settings for their residents (National Senior Citizens Law Center, 2005; U.S. Securities and Exchange Commission [SEC], 2006).
The need to extend equal protection to persons with dementia in AL becomes particularly compelling as intellectual functions deteriorate to the point when individuals can no longer engage in reliable decision-making needed to self-direct care in the manner AL promotes as a philosophy (Alzheimer's Association, 2009; Bynum, 2014). Persons with dementia should be protected from exploitation which may occur while executing a routine contract renewal featuring complex fee structures. Residents with dementia should be protected from neglect, abuse, and harm, especially as the capacity for self-care diminishes and responsibilities for an individual's well-being increasingly are assumed by DCWs. Environments should be safe and free of hazards that may not be known or recognized by persons with dementia. Staff should be sufficient in number and adequately trained as to provide programs and services that facilitate an individual's well-being. While ADA requirements are well-specified in some instances, such as the accommodations hotels must make for physically disabled guests (U.S. Department of Justice, Civil Rights Division, 2014), the systematic application of these requirements for AL residents with dementia appears lacking, despite the prevalence of dementia in AL.
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