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Nursing Home Environment May Exacerbate Alzheimer's Symptoms
> 6/1/2007 1:27:05 PM

A new study by Chicago's Rush Alzheimer's Disease Center indicates that senior citizens suffering from Alzheimer's undergo more rapid declines in cognition after being placed in nursing homes, particularly if they have no prior experience in adult care or assisted living situations.

While most Alzheimer's patients are cared for by a family member, the difficulties presented by the disease often give rise to unfortunate decisions regarding the living conditions and welfare of parents or other seniors who cannot subsist on their own without endangering their own health. Many experience mixed emotions when considering whether to send their loved ones into assisted living, moving them out of their own homes or those of their relatives. The transition from community to "institutional" life is, in most cases, understandably imperfect, creating unwanted stresses for patient and caregiver alike. Many seniors will be less than ecstatic about the prospect of transition to living in an unfamiliar environment, but the difference between isolation and consistent oversight is huge. Sympathetic company is crucial to the well-being of the Alzheimer's patient, and studies have suggested that social isolation may in itself facilitate the emergence of the disease or heighten its symptoms. Intellectual stimulation and interaction with peers have been shown to slow the degeneration process. In a contradictory finding, higher levels of education have been shown to both delay the onset of the disease and increase the speed of its definitive decline. Theory reads that better-educated seniors possess a greater neurological reserve that can hold out against the disease longer but that, once affected, loses its powers more quickly.

Retirement homes often feature organized social events and the regular company of other seniors, but adult day care offers these positive stimuli while allowing for a greater degree of free-will, even if patients return to the company of relatives after leaving the facilities each day. To make a very loose analogy, studies have found that children who attend pre-school on a regular basis are far less likely to display behavioral problems once they reach kindergarten. In both cases, the lifestyle changes inherent in relocation can be dramatic, and taking gradual steps in the process can better prepare those involved. While many older adults lack the power of self-sufficiency, they need to maintain contact with the outside world as often and in as many ways as possible. Even after controlling for the fact that those patients admitted to nursing homes are affected by more severe stages of the disease, researchers found that those individuals who did not make the transition and remained in the care of loved ones retained a greater degree of their cognitive functions over time.

Maybe this study's results can be attributed to a sense of abandonment or hopelessness common to seniors who've been placed in full-time homes. Whatever the cause, its clear that those with prior experience in day care were much better adjusted to assisted living and so maintained clearer mental facilities. Easing the transition, rather than waiting until Alzheimer's has made it absolutely neccessary for a patient to receive around-the-clock care, is the more effective and empathetic method.

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