Here we go again!

In 2015, Baycrest Memory Care failed four consecutive state surveys finding the facility not in substantial compliance with Oregon Administrative Rules for Residential Care Facilities and the facility's noncompliance placed residents at harm and risk for harm. 

In November 2016, sexual abuse was substantiated involving numerous residents. These cases were not criminally prosecuted. A new Baycrest Memory Care management team and the Department of Human Services assured our community that high quality care would now be the norm.

On Aug. 25, 2017, Baycrest Memory Care received an Order Imposing License Condition #RCFCD17-014.

Statement of Violation: Based on numerous pending Adult Protective Service Investigations and information received by the department it has been determined the facility not in substantial compliance with the Oregon Administrative Rules for Residential Care Facilities and the noncompliance places residents at harm or at risk for harm. Restrictions of Admissions were orderedand required minimum staffing was increased.

Specific violations were in areas of resident rights and protections, resident services, service plan, change of condition and monitoring medications, treatments staffing requests and training.

After checking with the Ombudsman website of substantial abuse, I found several troubling events. Case No. NB173161 on Aug. 28, 2017 and Case No. NB173026 Aug. 18, 2017. Each of these substantiated allegations resulted in a resident's fall with injury. Case No. NB171160 on May 17, 2017, substantiated an allegation of failure to protect a resident from inappropriate sexual contact. This being very disturbing due to recent sexual abuse cases already documented. Lastly, Case No. NB170808 on April 12, 2017, failure to provide service was substantiated with an outcome of deceased, meaning a resident had died.

On Spet. 22, 2017, an Amended Order Imposing License Condition was received. Again, the facility was found not in substantial compliance and cited more than seven more abuse investigations. The order also stated continued failure to comply may result in further sanctions up to and including the revocation of the facility's license.

Dementia is a progressive, fatal collection of neurodegenerative diseases. Alzhiemer's disease being the most talked about. Over time, dementia causes changes in memory, thought, language, behavior, mood, personality and catastrophic physical demise. It is the sixth leading cause of death. Co-morbid conditions such as coronary artery disease, chronic obstructive pulmonary disease, diabetes, depression and others must be managed along with dementia. To say the care is complex is understating the care issues.

Residents deserve quality care person-centered care beginning with a foundation of dignity and respect. Clearly, Baycrest Memory Care, licensed under Bay Area Properties LLCand owned by Radiant Senior Living are accountable and responsible for this persistent poor quality care.

The "best" in humankind, we are told, regularly emerges from the "worst" of situations. The residents at Baycrest Memory Care are waiting for the "best" to emerge. As an advocate for people with dementia, I ask this community to demand quality care for our vulnerable elderly population residing in memory care facilities. I call upon local health care leaders at Bay Area Hospital, North Bend Medical Clinic, physicians, nurses, pharmacists and families to give voice to this demand. 

Also, I call upon state representatives to take a stand against the Oregon Health Care Association. OHCA is the primary lobbyist for this "industry" and was instrumental in the defeat of HB-4083 from the 2016 legislative session. The 2017 session did produce the passing of HB-3359. OHCA was the primary writer of this bill. A bill which, even if it was in effect now, would not have provided any safety and security for current residents at Baycrest Memory Care nor hold facilities responsible for substandard care.

Here is what I advocate for.

• Guiding principles for best practices in dementia care. 

• The wishes and needs of individuals with dementia and families must be respected.  

• Practices must reflect compassionate, ethical, person-centered and high quality care across the continuum of the disease from early diagnosis through the end of life. 

• Practices must respect and incorporate ethnic, cultural, socioeconomic demographic and geographic diversity.

• Practices must integrate social and medical needs of individuals with multiple chronic diseases and disabling conditions, focusing on prevention or mitigation of crisis situations which will arise. 

• Care must be provided in the least restrictive environment with access to a sense of community. 

Also, here are a few evidence-based programs which can be implemented in any memory care facilty.

The STAR-VA program. The music and memory program. The Montessori-based program. The Snoezelen program. The Validation Technique program. 

From a facility licensing standpoint,it id time to move memory care facilities out of the residential care facility category. Resident care needs are presently at the acuity level of a nursing home. By designating memory care facilities under the nursing home category would automatically improve quality of care. One significant area of improvement would be the requirement to have licensed caregivers to provide the daily care. Under current state rules, an individual can provide direct care in a memory care facility after six hours of training and no license is required. After an additional six hours of training, an individual can pass medications and no license is required. 

Lastly, when a loved one is diagnosed with dementia and as this disease progresses, a quality of life begins to overcome quantity.

Thomas Blastic is an RN, Emeritus. He has practiced as an RN from 1977-2016. Currently licensed with OSBN with Emeritus status, focusing on advocacy.