This article compares and contrasts state regulations regarding minimum standards for the establishment of Special Care Units (SCUs). A case study approach is then used to assess the criteria for two special care units in Iowa (which requires licensure) and two special care units in Illinois (which does not require licensure). The article concludes with implications for family consumers and health care professionals related to placement decisions, research, policy development and consumer education.
Get full access to this article
View all access options for this article.
References
1.
1. Hall G & Buckwalter K: (1990). From almshouse to dedicated unit: Care of the institutionalized elderly with behavioral problems. Archives of Psychiatric Nursing. 4 (1), 3-11.
2.
2. US Congress Office of Technology Assessment (1992). Special care units for people with Alzheimer's and other dementias (report number OTA-H-543). Washington, DC: US Government Printing Office.
3.
3. Coons DH: (1983). The therapeutic milieu. In Reichel W. (Ed.), Clinical Aspects of Aging. Baltimore: Williams & Wilkens.
4.
4. Danford S: (1982). Therapeutic design for aging. In H. MacNeill (Ed.), Mental Health Interventions for Aging. Massachusetts: J. F. Bergin, Publishers, Inc.
5.
5. Lawton M: (1972). Assessing competence of older people. In D. Kent, P Katenbaum & S. Sherwood (Eds.), Research Planning and Action for the Elderly. New York: Behavioral Publications.
6.
6. Lawton M: (1980). The lifespan of housing environments for the aging. The Gerontologist. 20(1), 56-64.
7.
7. Coons DH:(1991). Activities and staff approaches: the impact on behaviors. In DH. Coons (Ed.) Specialized Dementia Care Units (pp. 161-174). Baltimore: John Hopkins Press.
8.
8. Mass ML, Hall CR, Specht JP, Buckwalter KC: (1992). Dedicated, not isolated: Development of long-term care Alzheimer's units. In K. Buckwalter (Ed.), Geriatric Mental Health Nursing: Current and Future Challenges (pp. 44-60). Thorofare, New Jersey: Slack and Company.
9.
9. Buckwalter KC, Hall G, Tripp-Reimer T, Payne J, Cerdner L, Cilmer J, Waterman J, Cruz G, & Wakefield B: (1993). Evaluation of Special Care Units (SCUs) For Alzheimer's Disease: Final Report to the Alzheimer's Association.
10.
10. Alzheimer's Association (1992). Guidelines for dignity. Chicago, Illinois.
11.
11. McCracken AL & Fitzwater E: (1989). Right environment for Alzheimer's: Which is better, open or closed units?Geriatric Nursing. 10(6), 293-294.
12.
12. Cleary TA: (1988). Reduced stimulation unit: Effects on patients with Alzheimer's disease and related disorders. Gerontologist. 28 (4), 511-514.
13.
13. Cluff PJ: (1990). Alzheimer's disease and the institution: Issues in environmental design. American Journal of Alzheimer's Care and Related Disorders and Research. (3), 23-32.
14.
14. Hall G, Kirschling MV, & Todd S: (1986). Sheltered freedom: An Alzheimer's unit. Geriatric Nursing. 7 (3), 132-137.
15.
15. Sloane PD & Mathew LJ: (1990). Therapeutic environmental screening scale. American Journal of Alzheimer's Care and Related Disorders and Research. (6),22-26.
16.
16. Zarit SH, Zarit, JM, & Rosenberg-Thompson S: (1990). Special treatment unit for Alzheimer's disease: Medical, behavioral, and environmental features. In T. L. Brink (Ed.) Mental Health in the Nursing Home (pp. 47-63). New York: The Haworth Press, Inc.
17.
17. Negley EN, & Manley IT: (I1990). Environmental interventions in assaultive behavior. Journal of Gerontological Nursing. 16 (3),29-33.
18.
18. Lovering MJ: (1990). Alzheimer's disease and outdoor spaces Issues in environmental design. American Journal of Alzheimer's Care and Related Disorders and Research. 5 (3),33-40.
19.
19. Randall P, Burkhardt SSJ, & Kutcher J: (1990). Exterior space for patients with Alzheimer's disease and related disorders. American Journal of Alzheimer's Care and Related Disorders and Research. 5 (4),31-37.
20.
20. Benson DM: (1987). Establishment and impact of a dementia unit within the nursing home. Journal of the American Geriatric Society. 35 (4), 319-323.
21.
21. Sloane PR Mathews LJ, Scarborough M, Desai JR, Koch GG & Tangen C: (1991). Physical and pharmacologic restraint of nursing home patients with dementia: Impact of specialized units. JAMA. 265 (10), 1278-1282.
22.
22. Anderson KH, Hobson A, Steiner P. & Rodel B: (1992). Patients with dementia involving families to maximize nursing care. Journal of Gerontological Nursing. 12 (7). 19-24.
23.
23. Carey B, & Hansen SS: (1986). Social work groups with institutionalized Alzheimer's disease victims. Journal of Gerontological Social Work. 9 (2),15-25.
24.
24. Linsk NL, Miller B, Pflaum R, & Ortigara-Viclk A: (1988). Families, Alzheimer's disease, and nursing homes. Journal of Applied Gerontology. 7 (3), 331-349.
26. Robinson A, & Spencer B: (1991). Reducing staff burnout in the dementia care unit. In D. H. Coons (Ed.)1 Specialized Dementia Care Units (pp. 144-160). Baltimore: Johns Hopkins Press.
27.
27. Wilson RW & Patterson MA: (1988). Perceptions of stress among nursing personnel on dementia units. American Journal of Alzheimer 's Care and Related Disorders and Research. 3 (4), 34-39.
28.
28. Iowa Administrative Code (1990). Chapter 61 (481-61 .1 3 through 481-6l.14). p. 19.
29.
29. Texas Department of Health (1989). Chapter 145, Subchapter X, 145: 301-145, 305-305.
30.
30. Washington Administrative Code (1989). 24814-211.
31.
31. Tennessee State Rule (1991). Chapter 1200-8-6-10, Special Care Units for Ambulatory Patients with Alzheimer's Disease and Related Disorders.
32.
32. New Jersey Department of Health (1992). Subchapter 45, 8:39-45.1 to 8:39-46.6.
33.
33. Weisman GD, Cohen U, Ray K, Arch Ma Day K, & Arch B: (I1991). Architectural planning and design for dementia care units. In D. H. Coons (Ed.), Specialized Dementia Care Units (pp. 144-160). Baltimore: Johns Hopkins Press.
34.
34. Iowa Administrative Code (1990). Chapter 58 (48 1-58.54 through 48 1-58.55), pp. 46-46.
35.
35. Hare J, & Pratt C: (1988). Burnout: Differences between professional and paraprofessional nursing staff in acute and long-term care facilities. Journal of Applied Gerontology7 (March), 60-71.
36.
36. Mobily P.Mass ML, Buckwalter KC, & Kelly LS: (1992). Geriatric mental health: Staff stress on an Alzheimer's unit. Journal of Psvchosocial Nursing. 30 (9), 25-31.
37.
37. Beitler DG: (1993). Looking at special care units from a consumer's perspective. Long Term Care Quality Letter. 5 (January 20), 6-7.