The Atlanta Journal-Constitution

■ Gaps in Georgia laws leave those suffering with dementia most at risk,

- By Carrie Teegardin cteegardin@ajc.com and Brad Schrade brad.schrade@ajc.com

Estimates are that as many as half of all residents in senior care homes suffer from cognitive impairment. That makes them particular­ly vulnerable to exploitati­on, abuse, injury and death.

But gaps in Georgia laws leave those with dementia most at risk.

Many of the severe violations that the AJC found in reviewing thousands of government records involved residents with Alzheimer’s or other dementia. That includes more than 100 cases over four years where residents wandered away from assisted living communitie­s and large personal care homes. Last month, just days before Thanksgivi­ng, Ozzie Murphy, who had Alzheimer’s, walked away from a Hapeville

facility after someone left a gate unsecured, according to police. He was found unconsciou­s the next morning in a church parking lot and pronounced dead at a hospital.

Many of the more than 90 abuse cases the

AJC identified also involved caregivers berating, slapping or punching residents with dementia. At Savannah Cottage at Chatham, a facility that has since changed hands, records show a caregiver persuaded a resident with dementia to perform sex acts in exchange for BC Powder and other gifts.

Despite the risks, officials at Georgia’s oversight agency told the AJC they do not keep a list of which assisted living communitie­s or personal care homes have memory care units.

The state does set some additional requiremen­ts for memory care units.

For example, caregivers who work in memory care units are required to get training within the first six months of employment on how to handle residents with dementia.

But the turnover is high at many facilities, and some fail to meet the training requiremen­ts.

Georgia also requires that enough staff at the senior care homes be on duty to “meet the unique needs” of residents. But the minimum standards for staffing in dementia care units are no different from the standards for those with no dementia residents: one caregiver for every 15 residents during the day; one for every 25 residents at night.

Those standards fall short of safeguards implemente­d in other states, including many in the South. Alabama and West Virginia are among the states that require higher staffing and separate licensing for facilities that serve those with advanced dementia. Alabama also requires that large facilities have a registered nurse.

Virginia enacted a new staffing standard. Mississipp­i requires that each resident with dementia receive three hours of direct care each day and that an RN or LPN be present on all shifts. North Carolina imposes additional training and staffing requiremen­ts for dementia units.

Georgia should require more nurse oversight in assisted living communitie­s and personal care homes, especially in memory care units, to better recognize health conditions including untreated chronic pain among residents who may not be able to verbalize their issues, said Ginny Helms, president of Leading Age Georgia, which represents not-for-profit and mission-driven organizati­ons serving seniors. The state also should mandate additional training for caregivers and better care plans for residents, she said. “Behaviors associated with Alzheimer’s and other neurocogni­tive disorders are the biggest challenge for staff in longterm care,” she said. “If a person is exhibiting ‘behavioral challenges,’ they are really expressing unmet needs.”

Many of the severe violations the AJC found in reviewing thousands of government records involved residents with Alzheimer’s or other dementia. That includes more than 100 cases over four years where residents wandered away from homes.

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