It is not easy to evaluate the results obtained by Alzheimer care units because of the small number of studies and their methodological differences. Comparative studies are made more difficult by the fact that many so-called special units do not fulfill all the necessary criteria. Where nursing homes are concerned, 22 to 27% of so-called special care units in fact fail to meet any of the criteria, and over 50% do not fulfill at least one of them. Of course, SCU cannot cure Alzheimer disease, nor stop or even delay its course ; it is still a fatal and very heterogeneous disease.

However, what SCU can do is :

• delay the decline of autonomy, according to certain studies, by helping to maintain the capacities required for the activities of daily living,
• improve behavioural problems. A recent study comparing the efficacy of treatment by neuroleptics or an inhibitor of serotonin uptake showed that neither was more effective than a placebo in general behavioural problems. A behavioural problem should not be treated haphazardly, but its nature should be carefully studied. Is it a mood disorder which could be helped by an antidepressant ? or a psychotic syndrome which could benefit from one of the new neuroleptics ? Does the patient present fugues, wandering or just disorientation, which will have to be tolerated ? Staff training can also significantly reduce episodes of aggressiveness.
• increase interaction within the care team. Within the SCU, physicians, nurses, nursing auxiliaries, psychologists and social workers all face a common problem. During staff meetings for gerontological evaluation, specialized staff can bring their experience to bear on patients’ specific problems.
• decrease staff turnover, since the disease is no longer something to be endured, which is inflicted or concealed ; on the contrary it is sought out and resisted, and knowledge of it is taught.
• increase the satisfaction of the families. One of the worst things is not to know from what we suffer, of what we die. Once the diagnosis has been announced, the family will generally be well aware of the disease with which they must contend. Family members can find support through the special skills available in the unit or through the family associations and support groups which are usually present there.

Alzheimer care units are an important element in the fight against the disease ; they are special places where patient care, teaching and research on Alzheimer disease can be combined.