Date of Award

1993

Document Type

Thesis

Degree Name

Master of Art

First Advisor

Arlene Taich

Second Advisor

Betty LeMasters

Third Advisor

Pamela Clark

Abstract

The purpose of this culminating project is to examine the care of Alzheimer's disease patients residing in a special care unit with the care received by those residing with the general nursing home population. More specifically, it compared the weights of patients on a special care unit with the weights of patients housed with the general nursing home population.

According to demographic information, the fastest growing cohort of the population is the older-old. This data is of great significance to health care providers for it is the 80 and above age group that are prime candidates to develop Alzheimer's disease. In addition, the possibility of institutionalization in a nursing home increases among this population.

Alzheimer's disease progresses through three stages. The disease first presents as a gradual loss of memory. The speed of progression varies between individuals but eventually culminates to complete loss of memory resulting in total dependence on others to provide basic needs. Various inappropriate behaviors are manifested in this disease due to the destruction of the brain. These behaviors, sometimes violent in nature, often force weary care givers to seek placement in a nursing home.

The long-term care industry provides basically two options of care for Alzheimer's disease patients. Living among the general nursing home population, an option chosen by many, leads to a lack of specialization as the nursing staff must contend with a multiplicity of diagnoses each presenting unique problems and needs. The patient to staff ratio tends to be higher with this option.

The second option available offers specialization in the care of demented geriatric patients. These special care units boast a staff that basically manages patients with one primary disease process. Because of this familiarity with the idiosyncrasies of this group, the staff becomes proficient dealing with the problematic behaviors. This broader knowledge base could result in better care. The staff to patient ratios tend to be lower in this care setting.

Review of the data available on both of the care options lead to this author's questions regarding the care rendered 1n each setting. This author theorized that care outcomes should be positive if the special care units are specialized in the care of Alzheimer's patients. The author chose weight loss as the care outcome to study. Alzheimer's patients are at risk to lose weight due to the complexity of their physical and mental functioning through the three stages of the disease. This author had also noted a high incidence of weight loss in Alzheimer's patients during involvement with the long-term care industry.

To test the theories, the author randomly selected thirteen patients from three nursing homes with special care units and thirteen patients from three nursing homes without special care units. Admission weights were compared to the most recent weights of the patients in the sample.

The research findings did support that patients residing in a special care unit did suffer less weight loss than those patients living among the general nursing home population. Both groups tended to suffer weight losses yet the non-special care unit group sustained the greatest amount of weight loss. Data gathered by this study is detailed in the Research Conclusions segment of this paper.

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