Zeisel J
World Hosp Health Serv. 2000;36(3):27-31, 36, 38.
As Alzheimer's disease becomes the most extensive and expensive disease in the world, the need to broaden the definition of treatment becomes more and more necessary. Medication is presently the first, and often the last, step in "treatment." But medication alone offers meager solace for the millions of people who live daily with this degenerative disease. The world they live in becomes increasingly strange and their behavior increasingly erratic. In order for most people with this disease to live lives that tend toward normalcy, a combination of pharmacological and non-pharmacological remedies is necessary. Therapeutic settings, activities that make up for cognitive deficits, family involvement, and caregiver approaches must augment medication. One non-pharmacological treatment modality is a physical environment that helps people find their way, jogs their memory, and keeps them safe. This paper recounts an investigative journey to discover what are the components of a multi-approach treatment for Alzheimer's disease, what role the physical environment plays in treatment, and what effects the physical environment has on the behavior of people with Alzheimer's disease. This paper describes and links the work of a small group of investigators and practitioners over the last decade of the 20th century (Zeisel, Hyde, Levkoff 1994; Hyde 1987; Zeisel, 1999; Zeisel and Raia, 2000; Zeisel, Silverstein, Hyde, Powell, and Holmes, 2001).
随着阿尔茨海默病成为全球最为广泛且耗费巨大的疾病，拓宽治疗定义的需求变得愈发必要。药物治疗目前是“治疗”的首要且往往是最后的手段。但对于数百万每天与这种退行性疾病相伴的人来说，仅靠药物治疗只能带来些许慰藉。他们生活的世界变得越来越陌生，行为也愈发古怪。为了让大多数患有这种疾病的人过上趋于正常的生活，药物治疗和非药物治疗相结合是必要的。治疗环境、弥补认知缺陷的活动、家庭参与以及护理方式都必须辅助药物治疗。一种非药物治疗方式是营造一个能帮助人们找到方向、唤起记忆并保障安全的物理环境。本文讲述了一段探索之旅，旨在发现针对阿尔茨海默病的多方法治疗的组成部分、物理环境在治疗中所起的作用以及物理环境对阿尔茨海默病患者行为的影响。本文描述并关联了20世纪最后十年一小群研究者和从业者的工作（蔡塞尔、海德、莱夫科夫，1994年；海德，1987年；蔡塞尔，1999年；蔡塞尔和拉亚，2000年；蔡塞尔、西尔弗斯坦、海德、鲍威尔和霍姆斯，2001年）。
