Dementia Care Complaints and Concerns

• Dementia in nursing facility residents is not carefully or accurately diagnosed, and sometimes is not diagnosed at all.
  
• Acute and chronic illnesses, depression, and sensory impairments that can exacerbate cognitive impairment in an individual with dementia frequently are not diagnosed or treated.
  
• There is a pervasive, general feeling among nursing facility administrators and staff that nothing can be done for dementia residents.
  
• Nursing facility staff members frequently are not knowledgeable about dementia or effective methods of caring for residents with dementia. They generally are not aware of effective methods of responding to behavioral symptoms in dementia residents.
  
• Psychotropic medications are used inappropriately for residents with dementia, particularly to control behavioral symptoms.
  
• Physical restraints are used inappropriately for residents with dementia, particularly to control behavioral symptoms.
  
• The basic needs of residents with dementia (such as hunger, thirst, and pain relief) may not be met because the individuals cannot identify or communicate their needs, and nursing facility staff members may not anticipate the needs.
  
• The level of stimulation and noise in many nursing facilities is confusing for dementia residents.
  
• Nursing facilities generally do not provide activities that are appropriate for residents with dementia.
  
• Nursing facilities generally do not provide enough exercise and physical movement to meet the needs of dementia residents.
  
• Nursing facilities do not provide enough continuity in staff and daily routines to meet the needs of residents with dementia.
  
• Nursing facility staff members do not have enough time or flexibility to respond to the individual needs of dementia residents.
  
• Nursing home staff members encourage dependency in residents with dementia by performing personal care functions, such as bathing and dressing, for them instead of allowing and assisting the residents to perform these functions themselves.
  
• The physical environment of most nursing facilities is too "institutional" and not "homelike" enough for residents with dementia.
  
• Most nursing facilities do not provide cues to help residents find their way.
  
• Most nursing facilities do not provide appropriate space for residents to wander.
  
• Most nursing facilities do not make use of design features that could support residents' independent functioning.
  
• The needs of families of residents with dementia are not met in many nursing facilities.

Source: Office of Technology Assessment, 1992.

Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.