Dementia Units in Long-Term Care. Sioane P, Mcdhew L (eds). Baltimore: Johns Hopkins University Press, 1 991 , 282 pages, hardcover, $45.00.
"Be tough on designers, gerontologists, or others who offer a quick fix for the full range of people with cognitive impairments," is the advice found in this report of a research study on how to provide nursing home care for individuals with Alzheimer's Disease and related disorders.
The sample of nursing homes with special care units and their comparison homes were drawn from California, New York, North Carolina, Ohio, and Texas. The five objectives of the study were to estimate the number of dementia units in the study states, to determine the range of variability of current dementia units in terms of 10 facets of each program, to determine the characteristics of dementia unit residents, to describe structural and process variables thought to characterize successful units, and to identify strategies and measures that can be used to study the effectiveness of dementia units.
The researchers met their objectives reasonably well. Dementia units are not homogenous entities, thus reducing some of the reliability of the data. Four types of dementia units were identified: "Ideal," "Uncultivated," "Heart of Gold," and "Rotten to the Core." Readers should enjoy the description of each of these types.
The strength of this book lies in the frank discussions of the "do's and don'ts," as well as the "should be's and ought not's" in setting up dementia units. Prominent consultants in dementia facility design and managment shared their views along with the opinions of the researchers. It is hoped that as more is learned about care of the demented elderly on special units, more specific books and manuals will be written. However, this volume provides a valuable beginning, especially since it includes the admonishment, "If your internal analysis fails to turn up a way of providing three critical elements (inunit space for group activities and dining, ability to segregate approximately 20-25 beds into a separate unit, and accessibility to outside areas), you should not continue with your feasibility study."
Adrninistrators and caregivers involved with the demented elderly on a special unit should read this volume, for tips on wise management and practice abound. Graduate students working with the demented elderly will also find the book useful, especially since ideas for further research are presented.