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A special care unit for acutely ill patients with dementia and challenging behaviour as a model of geriatric care

Die Geriatrisch-Internistische Station für Akuterkrankte Demenzpatienten (GISAD) als Innovatives Versorgungsmodell

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Zusammenfassung

Dieser Artikel beschreibt die Entwicklung eines innovativen Versorgungskonzepts zu Behandlung von Menschen mit Demenz, die in einem somatischen geriatrischen Krankenhaus stationär behandelt werden. Es wurde ein halb-geschlossener geschützter Spezialbereich für Patienten mit herausforderndem Verhalten eingerichtet, welches durch eine Demenz, eine Delir oder ein Delir bei Demenz bedingt ist. Innerhalb des Bereiches sind die Patienten in ihrer Mobilität nicht eingeschränkt. Die Milieugestaltung erzeugt eine möglichst wohnliche Atmosphäre. Tagesstrukturierende Maßnahmen führen zu Aktivierung und gewährleisten zusätzliche professionelle Präsenz. Es erfolgte eine intensives Schulungsprogramm für die Mitarbeiter. GISAD ist im Krankenhaus gut angenommen und wird als eine Verbesserung der Patientenversorgung angesehen. Die psychologische Belastung der Pflegenden hat trotz Selektion dieser schwierigen Patienten im Verlauf eines Jahres nicht zugenommen.

Abstract

This paper describes the development and management of a new model of care for hospitalized patients with challenging behaviour evoked by dementia and/or delirium. To ameliorate care for patients with dementia in a geriatric acute care hospital a segregated Special Care Unit for patients with challenging behaviour was created. Environmental features allow for safe and unrestricted ambulation within the unit and create a home-like atmosphere. Day-time activities structure the day and assure additional professional presence in the unit. An intensive training program for the staff was provided. The SCU has been well accepted by the staff and is considered to be an improvement in care. Psychological burden of the nurses did not increase over a time period of one year in caring for these difficult patients.

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Abbreviations

BPSD:

Behavioural and Psychological Symptoms of Dementia

LOS:

Length of Stay

SCU:

Special Care Unit

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Acknowledgements

The authors thank the team of the ward, especially head nurse Nelli Herrmann, for their courage to try a new model. We thank PD Dr. Klaus Hauer for his assistance with the manuscript and Hanne Detterbeck and Dr. Bettina Uhlfelder for their help with the database. Sponsor role This project was funded by a grant of the Otto- and Edith-Mühlschlegel Stiftung in the Robert Bosch foundation (Project number: 11.4.1365.0006.0). The sponsor had no influence on manuscript preparation. T. Zieschang is fellow of the Forschungskolleg Geriatrie of the Robert Bosch Foundation.

Financial disclosures The authors have no conflicts of interest.

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Correspondence to Tania Zieschang.

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Zieschang, T., Dutzi, I., Müller, E. et al. A special care unit for acutely ill patients with dementia and challenging behaviour as a model of geriatric care. Z Gerontol Geriat 41, 453–459 (2008). https://doi.org/10.1007/s00391-008-0023-3

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  • DOI: https://doi.org/10.1007/s00391-008-0023-3

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