Dementia Training Standards across Settings and Professions: A 50 State Analysis

Background: Quality-of-care fundamentally impacts care recipients’ quality-of-life and well-being. Professionals in long-term care and community-based settings may receive inadequate training on how to effectively serve people with Alzheimer’s disease and other dementias.

Objectives: To document states' legal requirements for professionals caring for people with dementias. To identify, through analysis and comparison, best practices and policy recommendations. To describe 2015 legislative activities with regards to best practices.

Methods: This two-part study analyzed laws regarding dementia training standards in 50 states, DC, and Puerto Rico.  A) Data collection entailed keyword searches of Lexis and Westlaw databases through 12/2014. Researchers tabulated data in 25 categories and three groupings: settings, professional licensure, first responders. State-to-state comparisons were based on the quantitative results of the research. Qualitative analyses identified best practices and policy implications. B) Analysts tracked dementia workforce training legislation through 9/2015. Qualitative methods will analyze data to describe recent legislative activity in terms of similarities and differences with best practices.

Results: Part A preliminary results indicate 22 of 52 states have laws prescribing training requirements for direct-care staff in nursing homes; only one of the 22 requires competency examinations.  Forty-five states require dementia care training for assisted-living facility staff;  31 of the 45 have heightened protections for Alzheimer's care unit residents. Nine states require dementia training for law enforcement. Policy recommendations, aligned with best practices, address use of detailed, regulatory curricula, competency-based assessments, and continuing education. Part B will be conducted after legislatures conclude their 2015 sessions.