This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status. No deleterious or beneficial effects were associated with SCU residence during a 6-month period.

The Tuckman-Lorge Questionnaire was used to study the attitudes of three groups of health workers toward old people and to test their acceptance of geriatric stereotypes. The health workers tested were medical students, housestaff members, and members of a mobile psychogeriatric screening team. Many significant differences were found between and within the groups tested, as well as between male and female subjects. The female housestaff had extremely high and significantly different scores from all other groups. The geriatric staff adhered least to the stereotypes. The results are discussed in the framework that the attitudes of care givers are directly related to the quality of the care provided. It is hypothesized that female housestaff members have special difficulties with role conflicts that cause them to adhere to stereotypes of the aged. The milieu of geriatric treatment, rather than knowledge of statistics about old people, is the most effective background for positive changes in attitudes toward the elderly.

Multiple educational approaches to the subject of hospital staff attitudes toward death were tested. It was not known which approaches, if any, would work, and it is still not known if one is better than another. The staff's resistance to discussing the topic of death seemed connected with a culturally-induced denial. Attempts to promote academic discussion failed. Not until situations occurred which provoked emotional involvement-an actual death, the staging of psychodrama involving death, seminars on religion and psychiatry, and attendance at an autopsy-could the staff members begin to understand their own feelings and open the way for true communication with their patients.