Any facility can hang out a shingle and claim to be an ADSCU, so beware of cheap imitations.  Some take patients with Alzheimer’s disease but have made limited modifications and train their staff with an annual in-service by their friendly neighborhood hospital social worker.  An assisted living may turn off stoves, or a skilled nursing designate a wing to Alzheimer’s disease.  In evaluating an ADSCU, caregivers should ask very clear questions about facility design and staff training.  They can also check with the local Alzheimer’s Association chapter who can often provide a list of facilities, comprehensive checklists of what to look for, and even where they have done staff training themselves.

In my experience, it is the people combined with training that truly make the ADSCU.  I have seen the most compassionate, professional staff in very nice facilities make the completely wrong decision due to a lack of disease specific training. I have also seen extraordinary care in cash strapped Veterans Administration ADSCUs because they have phenomenal people that are terribly well trained.  Obviously the best of all worlds would be these wonderful, well trained people in a state of the art facility.  The unfortunate reality is the right level of care may be too far away, not covered by insurance, or have a year long wait list. 

I have learned that it is difficult to predict which facility a family will prefer.  Case and point is that my own grandmother with Alzheimer’s disease is not in an ADSCU.   Some patients will do fine outside an ADSCU, for example an advanced patient with minimal Alzheimer’s disease management needs may be fine in a traditional skilled nursing facility.  Many facilities without the full range of design, activities and training still provide quality care for Alzheimer’s patients.  But it is vital to remember that Alzheimer’s disease requires very special care, and this care is usually best found in an ADSCU.

Using a quality ADSCU is one of the most frequent bits of advice I give to caregivers.  Fittingly, one of the places I learned this is from caregivers themselves.  Many of the horrors stories I hear about placements I feel are caused by an absence of disease specific training or a lack of appropriate facilities. If one cause of stress in the placement process is patients winding up in the wrong facility, then using a quality ADSCU is good stress prevention.

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