Selecting the Right Care Unit from Alzheimer's Outreach

What Exactly IS A Special Care Unit?
By Jennifer Rippke, RN

** Special Note**

Below is the actual criteria used for the SCU at Genoa Community Hospital/LTC, which happens to be the Nursing Home my mom is in.

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The Special Care Unit at Genoa Community Hospital/LTC is designed to meet the physical as well as the emotional, spiritual, and psychosocial well being of our residents with special care needs such as Alzheimer's Disease, Dementia's etc., that effect their mental processes. The goals of this unit are to provide a secure and safe environment, and produce a calm atmosphere. Activities are designed to meet each individual residents capabilities and needs on a daily basis.

We often think of dementing illnesses as a problem with memory loss. Memory loss is only part of the problem. As the brain deteriorates, thinking and judgment abilities decrease and the ability to adapt to new situations fails. Another problem is difficulty in communicating with persons who seem unable to understand or respond to others. These problems require those of us who are trying to communicate with persons with dementia to adapt our styles so that the person with the deterioration brain function can understand, process, and respond to us. Can you imagine yourself knowing what you wish to communicate and not being able to express your thoughts?

Some special tips for those trying to communicate to those with dementia.

1. Keep noise to a minimum to allow for complete concentration. Make the room quiet or take the person to a private setting to alow for minimal distractions.
2. Locate yourself in front of and at eye level with person, while using touch to assist the person to focus and concentrate.
3. Talk slowly, calmly, and directly, giving the person time to respond.
4. Use short 4 - 6 word sentences.
5. Repeat unanswered questions or comments using the exact words and phrases. Several repetitions may be necessary before you receive a response.
6. When asking a question requiring choices, limit the choices to 2.
7. Communicate with warmth, honesty, and feeling. Person with dementia or dementing illnesses are highly sensitive to facial expressions, body language, voice tones, and touch.
8. Communicate about subjects that may still be in memory--those events and special memories from the past.

The purpose of the Special Care Unit is to insure that residents are appropriately placed on the unit and kept on the unit only for the length of time where they can benefit from the special services on the unit. Only residents meeting the established criteria will be considered for placement in Special Care. The facilities Inter-disciplinary Care Plan Team is actively involved in determining appropriate placement and discharge from the unit.

Admission Criteria

I. Must have a diagnosis of Alzheimer's Disease, Dementia, or other related disorders.

2. Have a physician's order.

3. In the absence of a specific diagnosis, two or more of the following must be exhibited:

a. Wandering without purpose, attempting to leave the facility or their own home.
b. Physical behavior which is a danger to self and/or others.
c. Verbally inappropriate behavior (foul language, yelling out, which interferes with the rights of other residents.)
d. Disturbed sleep patterns.
e. Disorientation requiring special attention to maintain their activities of daily living

4. On the recommendation of the Inter-disciplinary Care Planning Team based on the individual residents circumstances and review.

Discharge Criteria

1. Advance stages of Alzheimer's Disease.

2. Special medical needs that exceed the level of care offered by the unit or facility.

3. Resident is no longer a danger to themselves and/or others.

4. Resident can longer benefit from the controlled environment or is disruptive to that environment.

5. On recommendation from the Inter- disciplinary Care Plan Team based on their review of the individual resident.

It is our goal to minimize the use of physical and chemical restraints through the use of a controlled environment, and help our residents remain as independent as possible. The unit should provide each resident and their families with a sense of"HOME" and the dignity, kindness, and care they deserve.

Alzheimer's Outreach http://alzheimers.zarcrom.com

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