Ferris S H, Steinberg G, Shulman E, Kahn R, Reisberg B
Home Health Care Serv Q. 1987 Spring;8(1):23-51. doi: 10.1300/J027v08n01_03.
Although home-care of Alzheimer's disease (AD) patients is more cost-effective than institutionalization, there is limited knowledge concerning the causes and prevention of institutionalization. The goal of this project was to determine the circumstances related to institutionalization of AD patients and to determine if a family counseling program can reduce these precipitating factors. In Study 1, we surveyed 109 family members of institutionalized AD patients. Primary precipitating factors included difficulties with patient behavior, insufficient auxiliary help and respite, financial difficulties, and caregiver emotional and physical complaints. In Study 2 we evaluated the effectiveness of an enhanced counseling program which included specific intervention techniques to cope with precipitating factors. For 41 AD family members who were seriously contemplating institutionalization, the precipitating factors prior to counseling were similar to those found in Study 1. After six months of individual counseling, home visits, and participation in caregiver support groups, there was only one placement, and a consistent reduction in the precipitating factors. These preliminary results suggest that a specially designed counseling program may delay or forestall institutionalization.
尽管对阿尔茨海默病（AD）患者进行居家护理比将其安置在机构中更具成本效益，但关于患者被安置到机构中的原因及预防措施的了解却很有限。本项目的目标是确定与AD患者机构化安置相关的情况，并确定家庭咨询项目是否能够减少这些促成因素。在研究1中，我们对109名机构化安置的AD患者的家庭成员进行了调查。主要促成因素包括患者行为方面的困难、辅助帮助和临时照料不足、经济困难以及照料者的情绪和身体问题。在研究2中，我们评估了一个强化咨询项目的效果，该项目包括应对促成因素的特定干预技术。对于41名认真考虑将患者安置到机构中的AD患者家属，咨询前的促成因素与研究1中发现的类似。经过六个月的个人咨询、家访以及参与照料者支持小组后，只有一例患者被安置到机构中，并且促成因素持续减少。这些初步结果表明，一个专门设计的咨询项目可能会延迟或防止患者被安置到机构中。
