BILL ANALYSIS
AB 528
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CONCURRENCE IN SENATE AMENDMENTS
AB 528 (Mullin)
As Amended August 20, 2003
Majority vote
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|ASSEMBLY: |49-25|(May 22, 2003) |SENATE: |23-14|(August 27, |
| | | | | |2003) |
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Original Committee Reference: HUM. S.
SUMMARY : Provides that Residential Care Facilities for the
Elderly (RCFEs) serving residents with Alzheimer's disease and
other forms of dementia train direct care staff on "sundown
syndrome" and describe activities available for residents to
decrease the effects of the syndrome.
The Senate amendments:
1)Replace the term "sundown syndrome" with the word
"sundowning."
2)Include other forms of dementia along with Alzheimer's disease
as conditions for which information and activities relating to
sundowning should be provided.
3)Refine the definition of "sundowning" to include "cognitive
impairment," and "disorientation" experienced by any person
whether elderly or not.
4)Remove language relating to the loss of visual clues due to
poor lighting and places this language in the uncodified
section of the bill.
5)Require the provision of information to direct care staff
about sundowning and the inclusion in the facility's plan of
operation a description of activities available for residents
to decrease the effects of sundown syndrome.
EXISTING LAW :
1)Provides for the licensure and regulation of RCFEs by the
Department of Social Services (DSS).
AB 528
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2)Establishes the Alzheimer's Disease Program, administered by
the Department of Health Services (DHS), which oversees 10
Alzheimer's Disease Research Centers of California (ARDCC) at
university medical centers throughout California, for the
purpose of research into the causes, treatment, cures, coping
strategies, prevention, incidence, and prevalence of
Alzheimer's disease and related disorders.
3)Establishes the Alzheimer's Disease and Related Disorders
Research Fund, administered by DHS, and establishes a tax
check-off option on the State Income Tax return to permit
Californians to make contributions.
AS PASSED BY THE ASSEMBLY , this bill:
1)Made findings and declarations relating to Alzheimer's disease
and related disorders.
2)Defined "sundown syndrome" as "recurring confusion and
increasing levels of agitation that coincide with the onset of
late afternoon and early evening."
3)Required DSS to "encourage residential care facilities for the
elderly that serve Alzheimer's patients to create activities
and programs that are designed to decrease the effects of
sundown syndrome by creating more activities in the late
afternoon and evening hours."
FISCAL EFFECT : According to the Senate Appropriations
Committee; negligible costs. Costs are borne by RCFEs.
COMMENTS : According to the author, "Sundown syndrome or
sundowning is defined as a syndrome of recurring confusion and
increasing levels of agitation, which coincide with the onset of
late afternoon and early evening. It is commonly associated
with patients suffering from dementia, commonly, Alzheimer's
patients. While the exact cause of sundown syndrome is not
known, experts believe there are several contributing factors.
These include physical and mental exhaustion (after a long day),
and a shift in the 'internal body clock' caused by the change
from daylight to dark. Some people with Alzheimer's disease
have trouble sleeping at night, which may contribute to their
disorientation. Sundown syndrome can be draining for the person
with Alzheimer's disease and his or her caregivers."
AB 528
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Representatives of caregivers support this effort to "provide
better services for elders that reside in residential care
facilities." Social workers practicing in this area note that
caring for a person with Alzheimer's disease or other forms of
dementia can be a particularly distressful experience,
especially when the caregiver is confronted with agitated or
anxious behaviors. Unlike purely physiological ailments,
dementia is experienced by many as behaviors within a social
context, which a caregiver may react to with feelings of
frustration, hurt, anger, or insult.
Analysis Prepared by : John Boisa/Casey McKeever / HUM. S. /
(916) 319-2089
FN: 0002992