Exploratory Study Of Family Visit Program For Alzheimer's Residents In Care Facilities

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Alzheimer's disease is a debilitating and progressive disorder. As Alzheimer's progresses, disease-driven changes occur in the individual. These changes include not only cognitive decline but also erosion of sensory perception and eventual loss of the individual's ability to interact and communicate. Communication problems experienced by those with Alzheimer's make interaction with family members and loved ones challenging. Family visits have been shown to have a therapeutic benefit. While the quality of family visits directly correlates to the quality of life for people with dementia, continued involvement of family members with loved ones in care facilities has implications for the quality of life of the family. Although family interaction and visits are important and may be desired, decreased communication abilities of people with Alzheimer's disease often make family and loved ones uncomfortable when anticipating a visit. Too often, such uneasiness and apprehension leads to abbreviated visits, if the visits even happen at all. Accordingly, developing interventions focusing on visits between people with Alzheimer's disease and their families is appropriate. Other interventions that focus on family visits of this sort have been developed, however, the intervention studied here, the Family Visit Program, is unique in that it explores the potential of the physical environment to enhance the quality of the visit experience. The Family Visit Program is an example of evidence-based design and includes four components: conversation corner, digital picture frame and stand, image selection process, and orientation process and communication strategies. The conversation corner served as the setting for the visits. Designed as a seating unit, it employs an upholstered curved bench with a high back, a canopy, and partitions at each end. The digital picture frame and stand were intended to serve as the display medium for the primary source of stimulation, personally meaningful photographs. Image selection was the process by which the families sorted through family photo collections to select images likely to evoke positive reactions from the resident as well as family. Family members were asked to complete image selection prior to the preparation meeting with the researcher. The orientation process consisted of the preparation meeting held with individual families during which images were scanned and communication strategies were discussed. The presented strategies were intended to enhance the quality of interaction and flow of conversation during the visit. This thesis was exploratory in nature. As such, the intent was not to test hypotheses but instead to identify a range of issues surrounding family visits with people with Alzheimer's disease living in care facilities. More specifically, the intent was to gain understanding about the potential of the Family Visit Program and each of its components to enhance the quality of the visit experience. The research was conducted at Longview, an elder care facility including both independent apartments and assisted living suites, located in Ithaca, NY. This study included three groups of participants: residents of Longview, family members of those residents, and Longview staff members. Four families participated in the research, though there were five resident participants. Two staff members participated in interviews. Each family participated in one visit as part of the Family Visit Program. There were three methods of data collection in this study: video recording of visits, interviews, and field notes. These three types of data were analyzed separately. This exploratory study was successful in attaining feedback on the potential and viability of the Family Visit Program and its components. The study demonstrates not only that the Family Visit Program components establish an appropriate framework for rewarding family interaction, but also that each component could benefit from further refinement.

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