NATIONAL PLAN TO ADDRESS ALZHEIMER'S DISEASE: 2017 UPDATE. Strategy 3.D: Maintain the Dignity, Safety and Rights of People with Alzheimer's Disease and Related Dementias

09/01/2017

Office of Long-Term Care Ombudsman Programs. ACL's Office of Long-Term Care Ombudsman Programs (OLTCOP) continues to provide training, technical assistance, and federal regulations that help states' long-term care ombudsman (LTCO) programs to better meet the needs of individuals living with dementia in long-term care facilities. These activities include a National Ombudsman Resource Center (NORC) webinar titled: LTCOP Rule: Supporting Person-Centered Advocacy -- Complaint Investigations and Abuse Reporting. OLTCOP continues to identify the complaint trend of improper evictions from both nursing homes and board and care settings; this has been the top complaint in nursing homes for the past 5 years and state Ombudsman programs report that persons with dementia who do not have their needs properly addressed are often at-risk of an eviction. The OLTCOP, along with other ACL staff, participate in a workgroup convened by CMS to identify systemic strategies to address this trend. In addition, the OLTCOP continues to work with states regarding the implementation of the LTCO rule, which became effective on July 1, 2016. ACL's Regional Support Centers incorporated states' LTCO rule implementation into their 2016 annual reviews and provide ongoing technical support focusing on conflict free, person-centered complaint resolution strategies. ACL will continue its evaluation of the impact of LTCO programs and practices generally, including those that affect residents living with dementia and their families.

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Elder Abuse Prevention. ACL's National Center on Elder Abuse (NCEA) is dedicated to protecting all from the many forms of elder abuse, including those with dementia. NCEA has rebranded and updated its fact sheets, research briefs and training materials. Many of these materials are adaptable to assist families in crisis especially when their family member has lost the capacity to make their own decisions and may be especially susceptible to harm by others. For example, a research brief on dementia is available. NCEA also consults with Alzheimer's Association chapters on elder abuse issues.

For more information, see:

  • http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_Dementia_ResearchBrief_2013.pdf
  • https://www.nia.nih.gov/about/events/2015/nih-workshop-multiple-approaches-understanding-and-preventing-eldr-abuse

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Model Approaches to Legal Assistance. The Model Approaches to Statewide Legal Assistance Systems (Model Approaches) grants help states develop and implement effective approaches for integrating low cost legal mechanisms into statewide legal/aging service delivery networks in order to enhance overall service delivery capacity. One program notable achievement is in Maine, which involved the launch of a financial institutions training initiative called Senior$afe. The grantee worked with representatives from the Maine Office of Securities, Maine Bureau of Professional and Financial Regulation, Adult Protective Services (APS), the Maine Bankers Association, and the Maine Credit Union League. Maine's grantee also developed a streamlined reporting system for financial institutions who wish to make a report without a customer's consent. Nebraska established a partnership with the Nebraska Bankers' Association through the APS state office to address financial exploitation issues. Several bankers who participated in training intend to work with APS on elder abuse and financial exploitation issues.

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Volunteer Representative Payee Pilot Program. The Social Security Administration (SSA) and ACL collaborated in development and testing of protocols and materials to assist in the identification and training of individuals to serve as volunteer representative payees. The materials developed include a manual for program implementation, protocol guidance relating to communications between SSA and APS, and forms for referrals. SSA is in the process of finalizing online training modules and continues to build awareness of the program through listening sessions and presentations. Once the modules are complete, SSA will conduct a media campaign to build awareness of this volunteer program.

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National Partnership to Improve Dementia Care in Nursing Homes. The focus of the National Partnership to Improve Dementia Care in Nursing Homes continues to be on the improvement of comprehensive dementia care in nursing homes across the country. The Partnership's larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices. In September 2014, the National Partnership, a public-private coalition, established a national goal of reducing the use of antipsychotic medications in long-stay nursing home residents by 25% by the end of 2015, and 30% by the end of 2016. Both goals were achieved and new goals are currently under development. CMS continues to monitor the reduction of antipsychotics, as well as possible consequences of the partnership, by utilizing antipsychotic measures on NHC; the agency's public reporting website. Data from NHC are also used to report progress quarterly, both nationally and regionally.

For more information, see:

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Person and Family Engagement Strategy. CMS issued a new Strategy to enhance person and family engagement that establishes definitions and consistency for frequently used terms to help people engage more fully in their health care, and serve as a guide to support meaningful, intentional application of person and family engagement principles to CMS's policies and programs addressing health and well-being.

For more information, see:

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