Gaps in Georgia laws leave residents with dementia most at risk

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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.

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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.

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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.

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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 LeadingAge 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 long-term care,” she said. “If a person is exhibiting ‘behavioral challenges,’ they are really expressing unmet needs.”

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