Global ratings of change in residents'physical, emotional, social and cognitive functioning were
obtained in interviews with family members of 67 special care unit (SCU) residents and 16 non-
SCU control group residents of an intermediate carefacility (ICF). In cumulative logistic regres
sion models, with adjustment for covariates (including length of residence in the facility), the
odds of being rated by family members as better in emotional and social functioning since enter
ing the facility were significantly greater for SCU than for non-SCU dementia residents. The
odds of being rated as better in emotional functioning were also significantly greater for resi
dents of the higher staffed SCU floor compared to residents of the lower staffed SCU floor. Rat
ings by institutional caregivers and data collected by direct observation were consistent with
these findings. Family members' perception of positive change among residents is a logically
desirable SCU outcome.
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References
1.
Agresti, A.
(1990). Categorical data analysis. New York: John Wiley.
2.
Albert, S.M.
, Del Castillo-Castaneda, C., Sano, M., Jacobs, D.M., Marder, K., Bell, K., Bylsma, F., Lafleche, G., Brandt, J., Albert, M., & Stem, Y. (1996). Quality of life in patients with Alzheimer's disease as reported by patient proxies. Journal of the American Geriatrics Society, 44,1342-1347.
3.
Berg, L.
, Buckwalter, K.C., Chafetz, P.K., Gwyther, L.P., Holmes, D., Koepke, K.M., Lawton, M.P., Lindeman, D.A., Magaziner, J., Maslow, K., Morley J.E., Ory, M.G., Rabins, P.V., Sloane, P.D., & Teresi, J. (1991). Special care units for persons with dementia. Journal of the American Geriatrics Society, 39, 1229-1236.
4.
Berlowitz, D.R.
, Du, W., Kazis, L., & Lewis, S. (1995). Health-related quality of life of nursing home residents: Differences in patient and provider perceptions. Journal of the American Geriatrics Society, 43, 799-802.
5.
Chafetz, P.K.
(1991). Behavioral and cognitive outcomes of SCU care . Clinical Gerontologist, 11, 19-38.
6.
Fisher, D.L.
, & Van Belle, G. (1993). Biostatistics: A methodology for the health sciences . New York: John Wiley.
7.
Gill, T.M.
, & Feinstein, A.R. (1994). A critical appraisal of the quality of quality-of-life measurements. Journal of the American Medical Association, 272, 619-626.
8.
Grant, L.A.
, Kane, R.A., & Stark, A.J. (1995). Beyond labels: Nursing home care for Alzheimer's disease in and out of special care units. Journal of the American Geriatrics Society, 43, 569-576.
9.
Green, R.
, Kutner, N., Stavisky, R., & Brown, P. (1996). Moderators of observed agitation in a dementia special care unit [Abstract]. In GSA [Gerontological Society ofAmerica] Preconference on Dementia Special Care Units: Recent findings andfuture directions (p. 7). Riverdale, NY: National Institute on Aging (NIA) Coordinating Center, Hebrew Home for the Aged.
10.
Holmes, D.
, Teresi, J., & Monaco, C. (1992). Special care units in nursing homes: Prevalence in five states. The Gerontologist, 32, 191-196.
11.
Holmes, D.
, Teresi, J., Weiner, A., Monaco, C., Ronch, J., & Vickers, R. (1990). Impacts associated with special care units in long-term care facilities. The Gerontologist, 30, 178-183.
12.
Kane, R.A.
(1994). Harbingers of the future? Seeking the "special" in the dementia special care unit. Alzheimer Disease & Associated Disorders, 8(Suppl. 1), S425-S428.
13.
Kiyak, H.A.
, Teri, L., & Borson, S. (1994). Physical and functional health assessment in normal aging and in Alzheimer's disease: Self-reports vs family reports. The Gerontologist, 34, 324-330.
14.
Lawton, M.P.
, Van Haitsma, K., & Klapper, J. (1996). Observed affect in nursing home residents with Alzheimer's disease. Journal of Gerontology: Psychological Sciences, 51B, P3-P14.
15.
Logsdon, R.G.
, & Teri, L. (1995). Depression in Alzheimer's disease patients: Caregivers as surrogate reporters. Journal of the American Geriatrics Society, 43, 150-155.
16.
Mattis, S.
(1988). Dementia Rating Scale professional manual. Odessa, FL: Psychological Assessment Resources.
17.
Mistretta, E.F.
, & Kee, C.C. (1997). Caring for Alzheimer's residents in dedicated units: Developing and using expertise. Journal of Gerontological Nursing, 23(2), 41-46.
18.
Montgomery, R.J.V.
(1994). Family measures in the special care unit context . Alzheimer Disease & Associated Disorders, 8(Suppl. 1), S242-S246.
19.
National Institute on Aging (NIA) Coordinating Center.
(1993). National Institute on Aging Collaborative Studies: Special care units for Alzheimer's disease: Common core data (Section I-B) . Riverdale, NY: NIA Coordinating Center, Hebrew Home for the Aged.
20.
Office of Technology Assessment (OTA), U.S. Congress.
(1992). Special care units for people with Alzheimer's and other dementias: Consumer education, research, regulatory, andreimbursement issues (p. 99). OTA-H-543. Washington, DC: Government Printing Office.
21.
Ory, M.G.
(1994). Commentary: Dementia special care: The development of a national research initiative. Alzheimer Disease & Associated Disorders, 8(Suppl. 1), S389-S394.
22.
Ory, M.
, & Leon, J. (1996). A decade of research on dementia special care units [Abstract]. In GSA [Gerontological Society of America] Preconference on Dementia Special Care Units: Recent findings andfuture directions (pp.4-5). Riverdale, NY: National Institute on Aging (NIA) Coordinating Center, Hebrew Home for the Aged.
23.
Russell, C.K.
(1996). Passion and heretics: Meaning in life and quality of life of persons with dementia. Journal of the American Geriatrics Society, 44, 1400-1402.
24.
SAS Institute, Inc.
(1990). SAS/STAT user's guide (Vols. 1 and 2). Cary, NC: Author .
25.
Sloane, P.D.
, Lindeman, D.A., Phillips, C., Moritz, D.J., & Koch, G. (1995). Evaluating Alzheimer's special care units: Reviewing the evidence and identifying potential sources of study bias. The Gerontologist, 35, 103-111.
26.
Sloane, R.
, & Mathew, L. (1991). Specialized dementia units in nursing homes. Baltimore: Johns Hopkins Press.
27.
Spector, W.D.
, & Takada, H.A. (1991). Characteristics of nursing homes that affect resident outcomes. Journal of Aging and Health, 3, 427-454.
28.
Swanson, E.A.
, Maas, M.L., & Buckwalter, K.C. (1993). Catastrophic reactions and other behaviors of Alzheimer's residents: Special unit compared with traditional units. Archives of Psychiatric Nursing, 5,292-299.
29.
Swanson, E.A.
, Maas, M.L., & Buckwalter, K.C. (1994). Alzheimer's residents' cognitive and functional measures: Special and traditional unit comparison. ClinicalNursing Research, 3, 27-41.
30.
Wagner, A.W.
, Teri, L., & Orr-Rainey, N. (1995). Behavior problems among dementia residents in special care units: Changes over time. Journal of the American Geriatrics Society, 43, 784-787.
31.
Wimberley, E.T.
, & Kutner, N.G. (1994). Atlanta case study: Determining what is "special" in an Alzheimer disease special care unit. Alzheimer Disease & Associated Disorders, 8 (Suppl. 1), S115-S125.
32.
Zanetti, O.
, Bianchetti, A., & Trabucchi, M. (1995). The puzzle of functional status in mild and moderate Alzheimer's disease: Self-report, family report, and performance-based assessment . The Gerontologist, 35, 148.
33.
Zimmerman, S.I.
, & Magaziner, J. (1994). Methodological issues in measuring the functional status of cognitively impaired nursing home residents: The use of proxies and performance-based measures. Alzheimer Disease & Associated Disorders, 8 (Suppl. 1), S281-S290.
