What to look for in an
Alzheimer's special care unit:

Staffing at a ratio of one staff person for every five residents on both the 7 a.m. to 3 p.m. and 3 to 11 p.m. shifts. On the overnight shift, the ratio can go as high as one staffer for every nine residents.

All direct care staff have received an approved 12 hour training program on Alzheimer's disease. Other staff, such as kitchen and maintenance workers, receive a two-hour training program.

Secure door systems guard against wandering.

An enclosed, safe, outside area allows residents to pace freely.

There are dining and activity rooms on the unit.

There is a director of the unit.

There is full-time activities specialist who works exclusively with patients in the unit.

The unit has scheduled therapeutic activities designed for Alzheimers patients - at least 60 hours a week for every 40 residents, or 1.5 hours per resident each week. (The best units have as many as 250 hours a week.)

The architectural design is simple and soothing and does not confuse the residents. Some features include soft bland colors, lighting that is bright but not glaring, the use of color coding and texture to identify rooms, doorways, and sleeping areas, floors that are a single, light color and not shiny, no background clutter, no mirrors.

There is a varied menu with many food options, including finger foods.

The goal is to have residents free of physical and drug restraints. A consultant works with the staff to see that medications are not the only way of controlling agitated residents.

What to look for in a nursing home without
a special care unit:

How many other residents with Alzheimer's disease are there? Ask to speak to their family members.

Is there a simple environment with lower levels of visual stimulation and noise?

Are doors and windows secure and does a security system prevent wandering outside?

Is there a staffing ratio of at least one staff person for every nine residents on all shifts?

What activities include the Alzheimer's residents?

Have any staff been trained specifically in caring for people with Alzheimer's disease?

What is the policy on the use of restraints?