STIMULATION - RETREAT PROGRAM FOR ALZHEIMERS PATIENTS

特殊护理病房（SCU）对阿尔茨海默病（AD）的影响 将对患者进行评估。 一个专门的程序的效果将是 与物理设计和单独处理的影响分开， 采用三组设计：（1）实验（E）组，50个单位， 设计的AD单元，其中个性化的多学科干预 将进行;（2）具有相似居民的物理相同单元， 指定用于AD患者，但不进行干预（对照组，C）， 和（3）一组50名在性别、认知损害、 和行为病理学，住在其他5个物理单元，其中一个更广泛的 存在AD和非痴呆居民的混合（分散对照）。 的 E和（C加上散射C）之间的对比将测试以下各项的全部影响： SCU; C和散射C之间的对比将测试 集群标准护理与非集群标准护理。 的 实验干预是基于劳顿-纳赫莫能力压力 生态模型，特别是在这个模型的方面， 将挑战与支持区分为最佳适应性 states. 专门的程序将尝试确定居民 作为一般人格，偏好刺激而不是退缩 随着时间的推移，偏好和状态的起伏。 刺激在 活动参与形式，ADL技能学习，社交技能，以及 个人成长将与允许撤退的干预措施相匹配， 对隐私的放纵和作为治疗媒介的依赖。 考核 基线、6个月和12个月间隔将评估以下方面的结局 生活质量（注意力、ADL、躁动、有意义时间 使用、社会行为、影响）和临床（医学、认知和 精神状况和药物使用）标准。

The impact of a special care unit (SCU) for Alzheimer's disease (AD) patients will be evaluated. The effects of a specialized program will be separated from the effects of the physical design and separate treatment by a three-group design: (1) The experimental (E) group, a 50-unit specially- designed AD unit in which an individualized multidisciplinary intervention will be conducted; (2) A physically identical unit with similar residents, designated for AD patients, but without the intervention (control unit, C), and (3) a group of 50 AD patients matched for sex, cognitive impairment, and behavioral pathology, housed in 5 other physical units, where a broader mix of AD and nondemented residents exist (scattered control). The contrast between E and (C plus scattered C) will test the full impact of the SCU; the contrast between C and scattered C will test the impact of clustered standard care versus nonclustered standard care. The experimental intervention is based on the Lawton-Nahemow competence-press ecological model and particularly on the aspect of that model that differentiates challenge versus support as routes to optimally adaptive states. The specialized program will attempt to determine resident preference for stimulation versus retreat as a general personality preference and as states that ebb and flow over time. Stimulation in the form of activities engagement, learning of ADL skills, social skills, and personal growth will be matched by interventions allowing retreat, indulgence of privacy, and dependence as therapeutic media. Assessment at baseline, 6-month, and 12-month intervals will assess the outcomes in terms of a number of quality of life (attention, ADL, agitation, meaningful time use, social behavior, affect) and clinical (medical, cognitive, and psychiatric conditions and medication use) criteria.