In 1989, Terence Cardinal Cooke Health Care center became the first long-term care skilled nursing facility in New York City to designate a unit to care for men and women with AIDS. The AIDS Unit accepts people who are in the advanced stages of the disease and require multiple medical services. With 156 beds, the unit has become a center of excellence and is one of the largest of its kind in New York.

An Environment for Living
Within the limitations of their illness, residents are provided with as much freedom as possible. Those residents who are well enough can take day trips to museums, walks in the neighborhood, and have overnight visits with family or friends. Continuing with everyday activities; discussing current events, playing cards, visiting with volunteers and family helps residents focus on living. As the disease progresses, AIDS can overwhelm the body, but not the spirit. Through pastoral care services, residents can receive spiritual guidance counseling which respects individual beliefs and religious affiliations.

The Joel Schnaper Memorial Garden provides an oasis of peace and tranquility for residents and visitors alike. The garden is specially designed to give people living with AIDS the chance to experience an awareness of nature. The healing garden also serves as an inviting location for social activities, ranging from parties to exercise classes to small gatherings. An automatic door, ramp and wide passages allow full accessibility throughout the garden.

Comprehensive Care
Few diseases threaten the personal dignity of the individual or require such compassion from caregivers as AIDS. Disabilities that often accompany the disease - paralysis, blindness, aphasia, and dementia - place great demands on residents, as well as on those who care for them. To help residents and staff cope with these challenges, psychologists offer support groups and counseling services.

Family members are encouraged to attend case conferences to discuss a residents care, ethical issues regarding dying with dignity, and other concerns. Resident councils meet regularly to discuss concerns and suggest ways of enhancing their lives at the Center.

The Discrete Unit provides a full range of medical services ranging from subacute-level care through palliative care. The Unit's dedicated staff includes:

• Primary Care and Specialty Physicians
  
• Dentists
  
• Physicians Assistants
  
• Nurse Practitioners
  
• Registered Nurses
  
• Licensed Practical Nurses and Certified Nursing Assistants
  
• Social Workers
  
• Psychologists
  
• Dietitians
  
• Occupational and Physical Therapists
  
• Speech Pathologists and Audiologists

In addition, hemodialysis, radiology and laboratory services are available on-site.

The health care team develops a coordinated care plan for each resident, which includes treatment with the latest medications and therapies, such as protease inhibitors. Residents who respond well to treatment may be able to return to living in the community. The goal of the Discrete Unit is to provide a high level of medical care so that residents do not require hospitalization. However, if an emergency necessitates this, the Center maintains agreements with every AIDS Center in New York City. To ensure continuity of care, residents are transferred to the original referring hospital whenever possible.

The Discrete Unit medical team actively participates in a number of research programs. Grant funded projects include a study of depression in persons with AIDS and a study of the effects of protease inhibitors. An affiliate of New York Medical College, the Center welcomes medical students who rotate through the Unit.