An Italian model of dementia special care unit: results of a pilot study

A small feasibility study was performed in Italy to evaluate whether the special care unit (SCU) model could minimize behavioral disturbances in demented patients. In a nursing home an area was selected to provide an appropriate environment for individuals with dementia. The physical environment was adapted, and the staff was trained to meet the needs of demented patients. Sixteen residents were transferred from traditional wards to the SCU. Functional status, cognitive performance, behavioral symptoms, and use of psychotropic drugs or physical restraints were assessed before and 6 months after admission to the SCU. Our findings show that transferring demented persons from traditional nursing home wards to an SCU significantly lessens behavioral problems but does not improve functional abilities or cognitive status after a short period of follow-up. Changes in caring strategies (in particular the use of physical restraints) seem to be important in reducing behavioral problems. The regional government of Lombardia (8.5 million inhabitants) decided to open small (20-bed) SCUs in 60 nursing homes (corresponding to 3.5% of the total nursing home beds in our region) and to reserve these units for demented patients with a high level of behavioral disturbances.