Coping with the intermingling of the lucid and confused

The issue of intermingling mentally lucid individuals and confused patients with behaviour problems has been a serious concern for the long-term care facility from the standpoints of the resident, relatives and staff. Efforts at Maimonides Hospital Geriatric Centre in Montreal have included "relationship therapy" (i.e., the relationship between the resident and staff members) to preserve the resident's self-esteem. Also, homogeneous groups of lucid and confused residents have been formed to help each take part in appropriate social activities. Lucid residents also are encouraged to attend weekly meetings with both professional and non-professional staff working on their floor. A staff psychiatrist experienced in psycho-pharmacology has significantly improved the problems created by intermingling these two groups. The psychiatrist also has helped staff reduce the stress caused by intermingling. In addition, staff members meet with relatives before and after admission of applicants to alleviate and discuss their concerns. Nevertheless, Maimonides and other long-term care institutions face the problem of how to reduce the damage of intermingling these two groups of residents.