The characteristics of Alzheimer's disease (AD) create specialized problems of care for the Alzheimer's patient. Treatment for AD victims does not only involve medical procedures; rather, Alzheimer's disease is what Kahn termed a bio-psycho-social phenomenon. 1 Since the epidemiology of the disease is not treatable as such, the emphasis of Alzheimer's care is on management of its physical, social, and psychological manifestations. Therefore, nursing home care and home health care are not sufficient for AD victims. Alzheimer's patients need the specialized care we've called Alzheimer's care, which is directed toward meeting the specific needs of AD victims and their families. It is generally agreed that both in stitutional and home settings are appropriate for treating certain characteristics of Alzheimer's disease, depending on the degree to which the disease has progressed, financial circumstances, and the family's ability and willingness to keep the patient at home. The choice between nursing home placement and home care is, of course, ultimately the decision of the primary caregiver or family. If caregivers are unable or unwilling to serve as the primary support for a victim-because of their financial considerations, their own infirmities, or because the responsibility for care becomes overwhelming-a family may feel that the decision to place the patient in a nursing home is the only alternative. In our experience, we have found that specialized Alzheimer's care, delivered in a home setting, can place the responsibility for primary care with home care professionals. The environment or treatment setting is highly significant in the management of Alzheimer's disease. We have found that of the two major settings for treatment ofAD patients-the institution and the home-the home is significantly more adaptable to Alzheimer's care. The home environment is familiar and can, with planning and training, be very helpful in the care plan. Home health personnel assigned to such cases can be specifically selected, trained, and supervised to maximize their effectiveness in providing the highest quality of Alzheimer's care. Under the assumption that many families do have a choice in treatment settings for an AD victim and that the home may be the more effective treatment setting, this article will seek to explain the adaptability of the home health option for Alzheimer's care.
