Alzheimer's Care

Author(s):  
Louise Woerner ◽  
Karen Casper

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.

1988 ◽  
Vol 7 (3) ◽  
pp. 331-349 ◽  
Author(s):  
Nathan L. Linsk ◽  
Baila Miller ◽  
Roberta Pflaum ◽  
Anna Ortigara-Vicik

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.


2013 ◽  
Vol 21 (3) ◽  
pp. 378-400 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Karin Støen Utvær ◽  
Unni Karin Moksnes

Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.


2020 ◽  
pp. 073346482094692
Author(s):  
Debra Parker Oliver ◽  
Abigail J. Rolbiecki ◽  
Karla Washington ◽  
Robin L. Kruse ◽  
Lori Popejoy ◽  
...  

Background and Objectives: Many family members struggle to negotiate their aging relative’s care with nursing home staff, potentially leading to depression and other negative outcomes for residents’ families. This pilot study tested an intervention designed to empower residents’ family members to attend and participate in nursing home care plan meetings. Research Design and Methods: We conducted a small, randomized, controlled trial of the Families Involved in Nursing home Decision-making (FIND) intervention, which used web conferencing to facilitate family participation in care plan meetings. Results: Overall, FIND was feasible and acceptable. Family members who received the FIND intervention were more likely to experience decreased depressive symptoms than those who did not. Discussion and Implications: FIND is a promising approach to reduce depression among family members of nursing home residents. Findings support the need for a follow-up clinical trial.


1990 ◽  
Vol 80 (5) ◽  
pp. 236-237
Author(s):  
CA Lund

The author discusses the establishment of the Nursing Home Care Unit at the Tampa Veterans Hospital. The role of the podiatric resident and the residency program in the care of the patients in the facility is presented.


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