The evaluation of an Alzheimer's disease special care unit for impact on resident behavior, functional and mental status and family perception of effectiveness

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Ross, Susan E.
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The Special Care Unit as an alternative to traditional care for residents of Personal Care Homes who suffer from Alzheimer's Disease (AD) and related disorders has proliferated in the USA while Canada has seen this trend developing over the past ten years. The primary features of the SCU are its small size, its home-like atmosphere, the staff to resident ratio, the special training for staff in working with AD residents, the multi-skilling of staff, access to outdoors and the involvement of families on the unit. The Sharon Home Inc., a 229 bed Personal Care Home located in Winnipeg's north end, has been operating a 14 bed SCU since the fall of 1997. Has the unit been effective in maintaining or improving the residents' mental, functional and behavioral status and do family members perceive the unit to be effective? In the survey portion of the evaluation, family members responded favorably to the unit. Family members were pleased with the flexibility in the meal service, the professional nursing care and the provision for safe wandering yet felt the unit was understaffed. Families felt that those features of the SCU that relate to the staff such as staff to resident ratio, training and multi-skilling of staff were more important than the home-like design, access to outdoors and involvement of families on the unit. Analysis of the retrospective baseline study results showed the unit to be effective in maintaining or improving functional status and only partially effective in improving behavioral status. Changes in mental status could not be determined due to lack of baseline data. Positive results were seen in improved resident weight. While results are limited due to the small sample size and the retrospective design of the study, they should serve as a basis for further evaluation of SCUs and their effects on staff, residents and families.