Catastrophic Reactions and Other Behaviors of Alzheimer’sResidents: Special Unit Compared With Traditional Units Elizabeth A. Swanson, Meridean L. Maas, and Kathleen C. Buckwalter zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONM Using a quasi-experimental pretesVposttest design, the effects of a Special Care Unit (SCU) on the incidence of catastrophic reactions and other behaviors of nursing home residents with Alzheimer’s disease (AD) were examined. Findings indicate significantly fewer catastrophic reactions and other selected behavior changes occurred during the posttest period for subjects in the experimental group compared with the subjects in the control group. Implications for psychi- atric consultation/liaison nurses (PCLNs) working with this vulnerable popula- tion are discussed. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Copyright 0 1993 by W.B. Saurtders Company ITH NO known cure for Alzheimer’s Dis- ease (AD) to date, management of this dis- ease and its secondary symptoms in both commu- nity and institutional settings is extremely important. Through the appropriate control of be- havioral disturbances associated with AD, nurses can enhance the quality of life for residents, fam- ily, and staff caregivers (Lawlor & Sunderland, 1988). Supporting this view, Teri and Logsdon (1990) note that behaviors can be potentially dan- gerous to caregivers, and Pillemer and Moore (1989) found that between 70% and 80% of nurs- ing home staff had been assaulted by residents. Psychiatric consultation liaison nurses (PCLNs) can play an important role in assisting long-term care staff and family caregivers to better under- stand and manage these problematic behaviors. Data from studies that approached problematic zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFED From the University of Iowa, College of Nursing, Iowa City, IA Address reprint requests to Nizabeth A Swanson, PhD, RN, Chair, Theory and Health Promotion, Associate Pro- fessor, University of Iowa, College of Nursing, Iowa City, IA 52242. Copyright 0 1993 by zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA W.B. Saunders Company 0883-9417/ 93lO705-0006$3.00/ O behavior differently, serve to further show the magnitude of the problem. Whall, Gillis, Yankou, Booth, and Beel-Bates (1992) found that more than a third of residents (36%) engaged in behavior seen by nursing staff as disruptive and more than three quarters of these residents (85%) were de- fined as memory impaired. Two national studies, the 1985 National Nursing Home Survey and the 1987 National Medical Expenditure Survey both found behavioral symptoms were more common in residents with dementia than in others (Lair & Lefkowitz, 1990; US Department of Health and Human Services, 1989). To enhance the quality of life for all caregivers, numerous researchers support the development of interventions to deal with the catastrophic behav- iors of persons with AD (Benson, Cameron, Hum- bath, Servino, & Gambert, 1987; Cleary, Clamon, Price, & Shullaw, 1988; Hall, Kirschling, & Todd, 1986). Psychiatric nurses have taken a lead- ing role in the development and implementation of the systematic evaluation of various management strategies. The environmental intervention of a Special Care Unit (SCU) in nursing homes is one model in need of evaluation of its effectiveness in control- 292 Archives of Psychiatric Nursing, zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPO Vol. VII, No. 5 (October), 1993: pp. 292-299