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of the study. One resident would come to the staff and say,“I want to hear my son. I’m here for my memory, and Ineed to be stimulated.” In another case, the tape was usedsuccessfully while the resident was transported to a newfacility.

A comparison of residents in whom agitation did notchange or became worse with those who used API suc-cessfully did not reveal any significant differences in base-line characteristics or number of episodes. Anecdotalinformation from the CRCs suggested that API was lesseffective for these four residents because it was appliedlate in the agitated episode or the resident was hallucinating.

More research clearly is needed before API couldbecome an evidence-based practice for LTC. Suggestionsfor future studies include a larger sample with more resi-dents and more intervention episodes, a better protocol tohelp families make the tapes, use of a tool that more di-rectly measures agitation (eg, any of those described byWeinrich, Egbert, Eleazer, and Haddock4), determinationof what types of behaviors and residents are most likely tobenefit from API by tracking more variables (eg, specificcognitive deficits or behaviors affected), and plans forchanges in study personnel.

The results of this study clearly pose more questionsthan provide answers. We hope our success and insightsinto the use of API will stimulate further research asnurses develop much needed nonpharmacologic interven-tions for this population.

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SUSAN MILLER, MS, RNC is the manager of the ICU/telemetryunit with Mercy Hamilton Hospital, Mercy Health Partners. PATRI-CIA E. H. VERMEERSCH, PhD, RN, is an adjunct assistant profes-sor at Wright State University. KELLY BOHAN, RNC, BSN, is anurse manager at Mercy Franciscan at West Park. KAREN REN-BARGER, MSN, RNC, CS, RHP, is the director of nursing for resi-dential care with Mercy Franciscan at West Park. AMY KRUEP,RNC, RHP, is a nurse manager with Mercy Franciscan at West.SHARON SACRE, RN, is the assistant director of nurses withMercy Franciscan at Schroder.

AcknowledgmentsThe authors would like the thank the residents, families, and staff of The Franciscan at Schroder, The Franciscan at St. Clare, TheFranciscan at St. Leonard, and The Franciscan at West Park, who mustface daily the challenges and struggles of dealing with Alzheimer diseaseand other dementing disorders. Without their unwavering support, thisstudy could never have occurred.

Funding was provided by an Alzheimer’s Grant from the GoldenEagle Fund of the Fraternal Order of Eagles.

Copyright © 2001 by Mosby, Inc.0197-4572/2001/$35.00 + 0 34/1/115200doi:10.1067/mgn.2001.115200

ON-LINE RESOURCES FOR PSYCHOEDUCATION

Alzheimer’s Association National Alliance for Mentally Ill www.alz.org www.nami.org

American Psychiatric Nurses Association National Alliance for Research on Schizophrenia and Depression www.apna.org www.narsad.org

Anxiety Disorders Association National Institute of Mental Healthwww.adaa.org www.nimh.gov

Depression and Related Affective Disorders Association National Mental Health Associationwww.med.jhu/edu/drada www.nmha.org