Purpose:  Assess over time the effectiveness of a theory-based psycho-educational training program, to improve nursing staff's knowledge of Alzheimer's disease (AD) and manage behavior problems of residents of the Alzheimer's care unit in long-term care facilities.

Design:  A one-group pre-test-post-test nonequivalent control design with repeated measures was used.

Sample:  Nursing staff (N= 51) on the Alzheimer's care units in four long-term care facilities in the Midwest attended four one-hour educational sessions.

Intervention and Outcome Variables:  A theory-based psycho-educational training program, (Progressively Lowered Stress Threshold-Model) was presented to the nursing staff. A dementia care coordinator was selected from the nursing staff to serve as a resource person for staff. The staff's knowledge of Alzheimer's disease and demographics were assessed at baseline, after the program, 3 and 6 months. The stage of dementia, level of functioning, use of psychotropic medications and physical restraints were assessed on AD residents at baseline, 2 weeks, 3 and 6 months post education program. An educational training manual was developed for staff to use after the program.

Methods:  Descriptive statistics were used to analyze the demographic data. Repeated measures analysis of variance was used to analyze the outcome variables.

Findings:  A significant difference was found between the pre-test and post-test scores for the nursing staff's knowledge of Alzheimer's disease. The average stage of dementia for AD residents (N=53) were 5.0 stage (moderate severe decline). There was a significant increase in the AD resident's limitations and functional ability overtime. The use of psychotropic medications and restraint use decreased but was not significant.

Conclusions:  The nursing staff had significant increase in Alzheimer's disease knowledge. AD resident's lack of ability with daily functions increased but decreased in behavior problems. The nursing staff applied the intervention to manage behavior problems and decreased use of psychotropic medications and use of restraints.