Opening an Alzheimers unit

[dinkymouse]

Our facility is planning to open a locked unit for dementia patients. They do not plan on having a nurses station inside this unit. The station will be down the hall on a regular unit. I feel this is a bad call. What if you are at the station and a problem occurs? You will have to run down the hall unlock the door and then run to whatever room the problem is in. There are to be two aides on the unit supposedly 1 will be able to get out of the situation long enough to run halfway down either end and page for a nurse. Some of these patients need 2-3 people to keep them contained when they are violent. The med cart and locked drugs will still be at the station and you will have to run back to the station for what ever you need. I don't know if they plan to have the charge for the open station be responsible for the locked unit or not. That would be an even more difficult situation. What are your units like and do you have this same type of station situation?

[CapeCodMermaid, RN]

Can you get some assistance from your local Alzheimer's Association for the best way to open a secure unit? Our dementia unit used to be 60 beds!! It was chaotic to say the least. We've now cut it down to 41 beds and shortly will be cutting it in 2...a Passages side and a Reflections side....

[CrunchRN, ADN, RN]

A very unsafe idea for residents and staff. I think consulting the Alzheimer's Association is a very good idea. That is not the standard for a locked dementia unit and your administration needs to know it. I am glad you see the issues and are advocating for everyone. Good luck!

[caroladybelle, BSN, RN]

Perhaps someone needs to run this idea by the local Board of Health, OSHA (for worker safety) and JCAHO.

It sounds way to scary for words.

[txspadequeenRN, BSN, RN]

As a alzheimers nurse in a totally locked down facility , I find this very unsafe:nono: . These people must be supervised all the time, when the two aides are in the rooms caring for people who will be watching over the floor. It sounds like the people that are running the show have no clue what they are doing. We make a great effort on our combative unit to have this unit completly staffed at all time with consistant staff. These type of patients have the potential to be highly combative , abusive toward other residents, escape , eat things they should not and be destructive to facility property. This is bad all the way around and I think I would be for trying to talk some sense into somebody.Good luck to you...

[dinkymouse]

That is a good suggestion. I am also taking some classes on dvd from them to become a certified Alzheimers care specialist so when I finish with that I think I will be more creditable with this facility. The Osha thing is a good idea if they continue with this idea. A nurse that had worked at a facility in town that nobody will send their relatives to and doctors even will only send their pts to if their is no where else, said this is how it is done at that facility and I replied but look at their reputation.

[Daytonite, BSN, RN]

The last nursing home I worked in had a beautiful Alzheimer's (Pavillion, they called it). There was no nursing station there, just a small desk for the aides to sit at to chart. It was locked and my nurses station was down the hall. Sometimes at night we would open up the doors to the Pavillion so the night aide wouldn't feel so isolated. It was easy enough to shut the door if a patient woke up and started wandering. The aides who worked in this unit were very specially trained and knew there had to be someone in there at all times--preferably two. We got in with a punch lock--the code was our telephone area code--very easy. We could also disable the door alarm if we wanted. The day shift kept their med cart down in the Alzheimer's unit and it was parked against one of the walls and locked. There were very few to no incidents of violence. The reason is because the aides were trained to take their time with these patients and let them do things at their own pace and time rather than impose routines on them. That cuts down on the anger and violence right away because you don't have arguments going on between the patients and the staff. I really don't remember violent incidences. We had people who wandered into other patients bathrooms and took items, but the other patient could have cared less and the aides knew what belonged to who. The kind of problems that occurred were very typical of any unit. Occassional falls or injuries and occassionally a patient went sour and died. The unit had it's own dining area and all the patients were assisted to sit at the tables and the aides helped them eat if necessary. They had a big screen TV to watch and the activities people spent a lot of time with them doing all kinds of stuff. I can honestly say that a lot of these people although confused were really cute. We also had an electronic tracking system. The wanderers wore an ankle transmitter. We had detection points at all the exits off the nursing units as well as the building exits. We knew immediately if someone was wandering out of the unit or even got as far as the front door. Any Alzheimer's patients who became so debilitated that they could barely move and had to be on tube feedings, etc. were moved out to the regular units because they were no longer a wandering danger. I was thinking that your patient who likes to use profanity and walk around naked would be a perfect candidate for this alzheimer's unit. I think you'll like it once it gets up and running.