Maas M
University of Iowa College of Nursing, Iowa City.
Nurs Clin North Am. 1988 Mar;23(1):57-68.
The care of residents with AD in long-term care facilities presents a number of challenges to nursing staff. The institutionalized person with AD displays a number of behaviors that are difficult to manage on traditional, integrated nursing units. In these units, behaviors such as wandering and falling are often managed by chemical and physical restraints. Multiple, complex stimuli, common on integrated units, contribute to the confusion and disorientation experienced by residents with AD. An alternative setting, the special-care unit designed specifically to meet the needs of residents with AD, has been described. Special-care units modify the environment of the traditional nursing unit to promote the safety of demented residents. The units are an attempt to reduce or control the amount of sensory stimulation in order to prevent catastrophic behaviors in the residents and maximize patient functioning. Staff on special-care units are selected specifically for their commitment to the unique care demands required by residents with AD. Ordinarily, staff in long-term care settings need specialized education to provide this care. A research project designed to evaluate the effectiveness of a special-care unit was also described. This research is valuable to residents with AD, their families, managers, and policy makers of long-term care institutions concerned with the effective use of resources. Considerable costs are involved in the construction and staffing of special-care units. However, the potential costs and threats to quality of care associated with care of residents with AD on traditional units make it imperative to evaluate the effectiveness of special-care units. With the increasing number of persons expected to develop AD, nurses, managers of long-term care facilities, and policy makers are faced with the difficult prospect of determining the most effective means of caring for these residents. Because there have been no definitive, comprehensive studies of special care units, there is an absence of empiric support for the many proposed advantages. Few studies have used systematic measurement techniques or measures with established reliability and validity. Given the growing number of elderly persons in the United States and the expected growth in the number of nursing home residents with AD, it is important to establish the value of special treatment units for residents with AD.
在长期护理机构中照顾患有阿尔茨海默病（AD）的居民给护理人员带来了诸多挑战。患有AD的机构化患者会表现出一些在传统综合性护理单元难以管理的行为。在这些单元中，诸如徘徊和跌倒等行为通常通过药物和身体约束来处理。综合性单元常见的多种复杂刺激会加重AD患者的困惑和定向障碍。一种替代设置，即专门为满足AD患者需求而设计的特殊护理单元已被描述。特殊护理单元对传统护理单元的环境进行了改造，以促进痴呆患者的安全。这些单元试图减少或控制感官刺激量，以防止患者出现灾难性行为并使患者功能最大化。特殊护理单元的工作人员是因其对AD患者所需独特护理要求的奉献精神而被专门挑选出来的。通常，长期护理机构的工作人员需要接受专业教育才能提供这种护理。还描述了一个旨在评估特殊护理单元有效性的研究项目。这项研究对于AD患者及其家人、管理人员以及关注资源有效利用的长期护理机构政策制定者来说是有价值的。特殊护理单元的建设和人员配备涉及相当大的成本。然而，在传统单元照顾AD患者所涉及的潜在成本和对护理质量的威胁使得评估特殊护理单元的有效性势在必行。随着预计患AD的人数不断增加，护士、长期护理机构的管理人员和政策制定者面临着确定照顾这些患者最有效方法的艰巨任务。由于尚未对特殊护理单元进行明确、全面的研究，对于许多提出的优势缺乏实证支持。很少有研究使用系统的测量技术或具有既定信效度的测量方法。鉴于美国老年人数量不断增加以及预计养老院中AD患者数量的增长，确定针对AD患者的特殊治疗单元的价值非常重要。
