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A report worth reading:

Science Daily — People with Alzheimer’s disease experience an acceleration in the rate of cognitive decline after being placed in a nursing home according to a new study by the Rush Alzheimer’s Disease Center. The study, published in the June issue of the American Journal of Psychiatry, finds that prior experience in adult day care may lessen this association.

The observational study involved 432 older persons with Alzheimer’s disease who were recruited from health care settings in the Chicago area. At baseline, they lived in the community and 196 participants were using day care services from 2 to 6 days a week for an overall mean of 1.7 days a week. At six month intervals for up to four years, they completed nine cognitive tests from which a composite measure of global cognition was derived.

On average, cognition declined at a gradually increasing rate for all participants. During the study period, 155 persons were placed in a nursing home, and placement was associated with a lower level of cognition and more rapid cognitive decline.

Study participants who had previous adult day care experience fared better. As level of day care use at study onset increased, the association of nursing home placement with accelerated cognitive decline substantially decreased. Thus, people using day care 3 to 4 days a week at the beginning of the study showed no increase in cognitive decline upon nursing home placement.

“The findings suggest that experience in day care may help individuals with Alzheimer’s disease make the transition from the community to institutional residence,” said study author Robert S. Wilson, Ph.D., a neuropsychologist at the Rush Alzheimer’s Disease Center.

I think this has a lot to do with the institutional setting most nursing homes offer. No matter how hard we try, a nursing home is not a HOME. And home is where people thrive and feel least threatened. As for this day care effect, it makes sense. Going to a center for a few hours every day - where activities and other opportunities for socialization are present, isn’t quite the shock a full blown nursing home admission IS. People are gradually prepared for the 9-5 business hours of nursing home activities…the other hours are spent very lonely and without socialization. Don’t ever underestimate the value of this. Even when an elderly person lives alone, they are engaging in self directed activities of their choice. In nursing homes they are not. This study makes perfect sense. Cognitive ability is related to the social needs of all people.

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