Suggested Criteria for Dismissal

of an Individual with Alzheimer's Disease or Related Disorders from an Assisted Living Facility*

1. A medical condition requiring skilled nursing care. This includes specialized nursing procedures that can not be performed in an assisted living facility.
   • Bedridden for 14 days or more
   • Stage III and IV pressure sores
   • Needs 24-hour skilled care for an extended period
   • A physician's order to move the individual to more skilled care
     
2. Diminished functional abilities that prohibit the individual from living in an assisted living facility at an appropriate level.
   • Unable to initiate activities of daily living (ADLs) without total assistance
     (such as bathing, dressing/grooming, toileting, continence mobility, eating)
   • Thought processing is severely impaired
   • The inability to communicate complicates pre-existing medical conditions
     
3. Behavior symptoms develop that pose a danger to the individual or the welfare of others. The setting has attempted to make a reasonable accommodation without success to address resident behavior in ways that would make move-out or change unnecessary. This should all be documented in the resident's records.
   • Aggressive behaviors and physical and verbal abuse by an individual changes so that they pose a danger to the individuals or others or go beyond the capacity of the facility to make reasonable accommodations and therefore become unmanageable for the facility.
   • The facility institutes plans and staffing to deal with wandering and is no longer capable of accommodating an individual's wandering. As a result, there is danger to the individual and others.
     
4. Pattern of non-compliance of care established.
   

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