Relocating adult day care: its impact on persons with dementia

The effect of familiarity on distraction and single cue use after hippocampal damage

Spatial disorientation frequently occurs in conditions such as Alzheimer's disease that damage the hippocampus, a brain structure necessary for learning and memory. Use of a single cue to mark a submerged escape platform in the Morris water test can reduce spatial disorientation in rats. If the cue used is a familiar one, disoriented rats perform the wayfinding task as well as control animals. However, in a real-world environment, cues rarely occur alone. This study examined whether rats with bilateral hippocampal lesions familiar with a cue performed the Morris water test as well as controls and faster than lesioned rats unfamiliar with the cue when a distracter was present. Bilateral electrolytic lesions were made in male rats that had received either familiarity with a cue or handling only. Familiar lesioned rats were introduced to the distracter on test days 1 (FB1) or 3 (FB3), and unfamiliar lesioned rats on day 3 (UB3). No significant differences were found for FB1 or FB3 rats and their respective controls. FB1 rats increased mean swim times on day 1 compared to preoperative day 4 (16.44 +/- 4.3 vs. 4.06 +/- 2.1 s, respectively, p < 0.03) but quickly adapted to the distracter. FB3 rats were slower than FB1 rats on day 3 (6.81 +/- 1.0 vs. 4.56 +/- 0.3 s, respectively, p < 0.05). UB3 rats were impaired on the task compared to FB1 rats on days 3-7 (p < 0.05). These findings suggest that cue familiarity is effective in the presence of a distracter and that the response of disoriented rats to a distracter is influenced by the amount of prior experience with the cue.

Relocating elderly people and nursing staff from the NHS to the independent sector

The results of the study reported here highlight the difficulties and potential problems facing re-provision programmes of mental health services. Relocation of services affects not only patients and staff, it also has implications for the education of staff and managers. Without appropriate preparation for relocation, the potential negative effects for older patients could be life threatening. For the staff, relocation could mean new ways of working for which they may not have been prepared. The current educational format does not appear to be sensitive enough to adapt to the pace of policy changes. The management process of re-provision programmes requires more than financial accounting. Preparation for relocation of patients and staff is of paramount importance to achieve the maximum benefits.