TRAIN:

At least half of all nursing home residents have Alzheimer's disease or
another dementia. In our area, we estimate more than 65,000 persons have
Alzheimer's, which affects more than 130,000 caregivers.

For families, quality care means tangibles such as safety and nourishment as
well as intangibles like dignity for their loved one. The families we serve
indicate that the most important component affecting quality care is
well-trained staff.

Regardless of which side of the Mississippi you live on, enhanced training
can influence and improve the quality of care. In 2001, Missouri passed
leading-edge legislation requiring anyone employed to care for a person with
Alzheimer's to receive dementia-specific training. These skills include
communication tips, skills for managing challenging behavior and how to work
with the person's family as a care team. Last year, we trained more than 5,500
direct care staff.

In addition to training, the states should focus on homes with repeated
problems and not penalize those nursing homes that are providing good care.

For the past three years, the Alzheimer's Association has joined with other
senior advocacy groups in support of the adult protection legislation. As we
move to a new legislative session in Missouri, we urge continued advocacy by
Gov. Bob Holden, Lt. Gov. Joe Maxwell, care providers and advocates to gain
passage of a bill that elevates quality of care for all individuals. The bill
should strengthen sanctions against poor-performing facilities, including
ensuring that fines are enforced. The bill should also include other important
provisions such as strengthening criminal background checks.

There are many good nursing homes in our area, and we should recognize the
value and support they provide families. Too often families are made to feel
guilty about nursing home placement, even in a good facility. Families can
learn to team with a nursing home to provide quality care with dignity and
affection for their loved one with Alzheimer's.

A FORUM FOR OTHER VOICES, IDEAS AND OPINIONS\

Joan D'Ambrose is executive director of the Alzheimer's Association, St.
Louis Chapter, which serves 38 counties in eastern Missouri and western
Illinois.