Training staff to work in special Alzheimer ' s units

Dorothy H. Coons is a Research Associate in the Institute of Gerontology, The University ofMichigan; Co-editor of the book A Better Life: Helping Family Members, Volunteers, and Staff Improve the Quality of Life of Nursing Home Residents Suffering from Alzheimer's Disease and Related Disorders; and 1988 designated recipient of the Clark Tibbitts Award from the Association for Gerontology in Higher Education for her contributions to the advancement ofgerontology in institutions of higher learning. Introduction This article will focus on the content and methodology that are essential in training staff to work in residential care units for persons with Alzheimer's disease or related dementias. Special Alzheimer's units are now being established throughout the country in increasing numbers in an attempt to provide better care for this special group of elderly. The need for specially designed units is evident. They have the potential for offering a quality of life that will enable cognitively impaired persons to live with dignity and with a degree of serenity. These settings will attain a high quality of care, however, only if those who are establishing them have a clear understanding of how to design a milieu that will meet the social and psychological needs of those in the middle stages of Alzheimer's disease, and recognize the differences between the residential care setting and the nursing home. 2,5,6,9 Separate housing for this population is only a first step in designing appropriate environments. A comprehensive design for residential care needs to take into account the physical environment, the opportunities to be made available to residents for continuing involvement in the world around them, and special training that prepares staff to discard their role of caretaker. Much is known now about ways to provide the appropriate physical environment to enable impaired persons to manage maximally.4'7'8 Other essential factors are more complex and less clearly understood. Training methods have been developed and tested for teaching staff