TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER c: LONG-TERM CARE FACILITIES
PART 225 ALZHEIMER'S DISEASE MANAGEMENT CENTER DEMONSTRATION PROGRAM CODE
SECTION 225.3030 ACTIVITY PROGRAM
Section 225.3030 Activity Program
a) The facility shall provide an ongoing program of activities to meet the interests and preferences and the physical, mental and psychosocial well-being of each resident, in accordance with the resident's comprehensive assessment. The activities shall be coordinated with other services and programs to make use of both community and facility resources and to benefit the residents.
b) Activity personnel shall be provided to meet the needs of the residents and the program.
1) Activity staff time each week shall total not less than 45 minutes multiplied by the number of residents in the facility. This time shall be spent in providing activity programming as well as planning and directing the program. The time spent in the performance of other duties not related to the activity program shall not be counted as part of the required activity staff time.
2) Activity personnel shall have the background and education necessary to be able to implement drama, music, and art therapeutic technique.
c) Activity personnel working under the direction of the activity director shall have a minimum of 10 hours of in-service training per calendar or employment year, directly related to recreation/activities. In-service training may be provided by qualified facility staff and/or consultants, or may be obtained from college or university courses, seminars and/or workshops, educational offerings through professional organizations, similar educational offerings or any combination of these sources.
d) Activity Director
1) A trained staff person shall be designated as activity director and shall be responsible for planning and directing the activities program. This person shall be regularly scheduled to be on duty in the facility at least four days per week.
2) The activity director shall be a certified Therapeutic Recreation Specialist.
3) The activity director shall have a minimum of 10 hours of continuing education per year pertaining to activities programming.
e) Written permission, with any contraindications stated, shall be given by the resident's physician if the resident participates in the activity program. Standing orders will be acceptable with individual contraindications noted.
f) Activity program staff shall participate in the assessment of each resident, which shall include the following:
1) Background information, including education level, cultural/social issues, and spiritual needs;
2) Current functional status, including communication status, physical functioning, cognitive abilities, and behavioral issues; and
3) Leisure functioning, including attitude toward leisure, awareness of leisure resources, knowledge of activity skills, and social interaction skills and activity interests, both current and past.
g) The activity staff shall participate in the development of an individualized plan of care addressing needs and interests of the residents, including activity/recreational goals and/or interventions.
h) The facility shall provide a specific, planned program of individual (including self-initiated) and group activities that are aimed at improving, maintaining, or minimizing decline in the resident's functional status, and at promoting well-being. The program shall be designed in accordance with the individual resident's needs, based on past and present lifestyle, cultural/ethnic background, interests, capabilities, and tolerance. Activities shall be daily and shall reflect the schedules, choices, and rights of the residents (e.g., morning, afternoon, evenings and weekends). The residents shall be given opportunities to contribute to planning, preparing, conducting, concluding and evaluating the activity program.
i) The activity program shall be multifaceted and shall reflect each individual resident's needs and be adapted to the resident's capabilities. The activity program philosophy shall encompass programs that provide stimulation or solace; promote physical, cognitive and/or emotional health; enhance, to the extent practicable, each resident's physical and mental status; and promote each resident's self-respect by providing, for example, activities that support self-expression and choice. Specific types of activities may include:
1) Physical activity (e.g., exercise, fitness, adapted sports);
2) Cognitive simulation/intellectual/educational activity (e.g., discussion groups, reminiscence, guest speakers, films, trivia, quizzes, table games, puzzles, writing, spelling, newsletter);
3) Spiritual/religious activity (e.g., religious services, spiritual study groups, visits from spiritual support groups);
4) Service activity (e.g., volunteer work for the facility, other individuals and/or the community);
5) Sensory stimulation (e.g., tactile, olfactory, auditory, visual and gustatory);
6) Community involvement (e.g., community groups coming into the facility for intergenerational programs, special entertainment and volunteer visits; excursions outside the facility to museums, sporting events, entertainment, parks);
7) Expressive and creative arts/crafts (adapted to the resident's capabilities), music, movement/dance, horticulture, pet-facilitated therapy, drama, literary programs, art, cooking;
8) Family involvement (e.g., correspondence, family parties, holiday celebrations, family volunteers); and
9) Social activity (e.g., parties and seasonal activities).
j) Residents' participation in and response to the activity program shall be documented at least quarterly and included in the clinical record. The facility shall maintain current records of resident participation in the activity program.