A moving experience: reconfiguring a special care unit for Alzheimer's patients

Eight years after opening, the patient mix on a 64-bed Special Care Unit (SCU) for Alzheimer's residents had become too diverse to allow the intended programming to be carried out. The unit was carefully reconfigured with residents moving within, to, and from the unit. Successful moves typically involve residents in pre-move planning and preparation activities, but since this isn't feasible with dementia patients, extensive planning, training, and preparation of staff substituted for the involvement of residents. The move met its objectives: resident mix and programming are back to the original intent, and quality of life has improved. Improved discharge policies maintain homogeneity of resident levels on the unit. The change produced unexpected changes, and staff, particularly the Certified Nursing Assistants (CNAs), had to make immediate adjustments. Greater CNA involvement is recommended.