The successful establishment and development of specialized nursing home services for Alzheimer patients is greatly influenced by the attitude of management and staff. A nursing home program will not extend beyond the shadow of its leaders. It is essential that the administrator be committed to developing better services for the Alzheimer patient.Two schools of thought exist among nursing home administrators regarding separation of the Alzheimer patient from other patients. One approach is based on the concept that all Alzheimer patients should be grouped together in a separate unit. This arrangement has advantages from the standpoint of control, convenience, and better supervision. Such units can be designed to provide security and meet many of the specialized needs of the patient. Critics of this method quickly point out the need for those afflicted with Alzheimer’s to socialize with other patients.

The second concept-nonsegregation of the Alzheimer patient allows those suffering from Alzheimer’s disease to be integrated into the regular program of the nursing home. Too frequently this arrangement does not provide adequately for the special needs of patients. The general trend is to establish separate units with specialized programs and trained staff. However, the success of Alzheimer programs will mainly be deter mined by the staff and how well they are trained. Nursing homes that seem to be the most effective are those where the staff believe that constructive things can be done for and with the Alzheimer patient. Families need to look for those homes that are flexible and open-minded in their approach to the patient. It is extremely important that the staff demonstrate understanding and affection toward Alzheimer patients. When visiting a nursing home, notice the interaction of the staff with the patients, Are patients introduced by name? Does the administration have someone on staff to show the facility, to point out special features and programs designed for Alzheimer patients, and to answer any questions that might arise? Are there specialized activity programs for Alzheimer patients?

Standards

Nursing homes must comply with state and local laws, whose standards have been developed for the care and protection of the patient. Each state has its own survey system for assuring that patients receive adequate care. Until recently the process focused on structural requirements more than on patient outcomes. This is beginning to change with new guidelines being developed to assess the quality of care provided by facilities. Standards of care include such things as ensuring that patients are receiving the specific diets ordered by their doctors, that grooming meets acceptable standards, and that medications are being dispensed properly. Accreditation reviews are very thorough, and generally take a full week to complete.

Part of the process of selecting a nursing home for Alzheimer patients involves determining that the prospective home complies with existing state regulations. Inquiries should also be made into what rating the home has been given, if a rating system exists in the caregiver’s state. Is the home considered to be superior? These questions can be answered by the nursing home administrator.

When visiting a home, ask the administrator for the Bill of Rights for Residents of Nursing Homes, which all nursing homes are required to provide.

The Bill of Rights should include the following principles -

1. The rights of Citizenship
2. The right to Dignity
3. The right to Privacy
4. The right to Personal Property
5. The right to Information
6. The right to Freedom
7. The right to Care
8. The right to Choose
9. The right to Residence
10. The right to Expression

Most states currently do not have separate standards and guidelines for the development of specialized nursing homes for Alzheimer patients. Some states are just beginning this task. The development of standards for Alzheimer facilities requires special consideration due to the uniqueness of the disease. The traditional programs will not suffice for the Alzheimer patient. There are different phases of the disease, and required treatment varies in each phase. A progressive program must be put in place, one that will allow for the various changes that take place in the patient’s behavior.

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