MS, Assistance + LLC, 5 Whistling Swan Road, Hilton Head Island, SC 29928, USA.
Gerontologist. 2010 Apr;50(2):192-203. doi: 10.1093/geront/gnp115. Epub 2009 Jul 24.
This study examines transitioning residents with Alzheimer's disease or a related disorder (ADRD) from assisted living facilities (ALFs) to memory care units (MCUs) from the perspective of 3 ALF organizational models: freestanding ALFs, ALFs with MCUs, and ALFs in continuing care retirement communities (CCRCs) with MCUs.
In-depth interviews were conducted with 37 ALF administrators, representing the 3 ALF types. Grounded theory identified major themes. Thematic analysis organized content. The constant comparison method compared themes among ALF types.
Administrators in freestanding ALFs were notably more likely to discuss transfer policies on admission. CCRCs with MCUs were more likely to make multidisciplinary decisions. In ALFs with MCUs, typically, the administrator and the director of nursing or resident care coordinator decided. In all ALFs, challenges included family resistance and denial of deficits, although there was notably less resistance in freestanding ALFs. CCRCs were much less likely than ALFs with MCUs to have trial admissions.
ALF administrators may reduce family resistance to the MCU transfer by maintaining ongoing dialogue with family, discussing transfers at admission, conducting periodic resident reassessments, and providing opportunities for families to learn about ADRD.
本研究从三种辅助生活设施（ALF）组织模式的角度，即独立的 ALF、设有记忆护理单元（MCU）的 ALF 和设有 MCU 的持续护理退休社区（CCRC）中的 ALF，研究患有阿尔茨海默病或相关障碍（ADRD）的居民从辅助生活设施（ALF）向记忆护理单元（MCU）的过渡。
对 37 名 ALF 管理人员进行了深入访谈，代表了这 3 种 ALF 类型。扎根理论确定了主要主题。主题分析组织了内容。恒定比较法比较了 ALF 类型之间的主题。
独立 ALF 的管理人员在入院时更有可能讨论转移政策。设有 MCU 的 CCRC 更有可能做出多学科决策。在设有 MCU 的 ALF 中，通常由管理员和护理主任或居民护理协调员决定。在所有的 ALF 中，都存在家庭的阻力和对缺陷的否认，尽管在独立的 ALF 中阻力明显较小。与设有 MCU 的 ALF 相比，CCRC 进行试验性入院的可能性要小得多。
ALF 管理人员可以通过与家属保持持续对话、在入院时讨论转移、定期对居民进行重新评估以及为家属提供了解 ADRD 的机会，来减少家属对 MCU 转移的阻力。
