Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

Small-scale, homelike facilities versus regular psychogeriatric nursing home wards: a cross-sectional study into residents' characteristics

Hilde Verbeek1*, Sandra MG Zwakhalen1, Erik van Rossum12, Ton Ambergen3, Gertrudis IJM Kempen1 and Jan PH Hamers1

Author Affiliations

1 School for Public Health and Primary Care: CAPHRI; Faculty of Health, Medicine and Life Sciences; Department of Health Care and Nursing Science; Maastricht University; the Netherlands

2 Centre of Research on Autonomy and Participation, Zuyd University of Applied Sciences, Heerlen, the Netherlands

3 School for Public Health and Primary Care: CAPHRI; Faculty of Health, Medicine and Life Sciences; Department of Methodology and Statistics, Maastricht University, the Netherlands

For all author emails, please log on.

BMC Health Services Research 2010, 10:30  doi:10.1186/1472-6963-10-30

Published: 29 January 2010

Abstract

Background

Nursing home care for people with dementia is increasingly organized in small-scale and homelike care settings, in which normal daily life is emphasized. Despite this increase, relatively little is known about residents' characteristics and whether these differ from residents in traditional nursing homes. This study explored and compared characteristics of residents with dementia living in small-scale, homelike facilities and regular psychogeriatric wards in nursing homes, focusing on functional status and cognition.

Methods

A cross-sectional study was conducted, including 769 residents with dementia requiring an intensive level of nursing home care: 586 from regular psychogeriatric wards and 183 residents from small-scale living facilities. Functional status and cognition were assessed using two subscales from the Resident Assessment Instrument Minimum Data Set (RAI-MDS): the Activities of Daily Living-Hierarchy scale (ADL-H) and the Cognitive Performance Scale (CPS). In addition, care dependency was measured using Dutch Care Severity Packages (DCSP). Finally, gender, age, living condition prior to admission and length of stay were recorded. Descriptive analyses, including independent samples t- tests and chi-square tests, were used. To analyze data in more detail, multivariate logistic regression analyses were performed.

Results

Residents living in small-scale, homelike facilities had a significantly higher functional status and cognitive performance compared with residents in regular psychogeriatric wards. In addition, they had a shorter length of stay, were less frequently admitted from home and were more often female than residents in regular wards. No differences were found in age and care dependency. While controlling for demographic variables, the association between dementia care setting and functional status and cognition remained.

Conclusions

Although residents require a similar intensive level of nursing home care, their characteristics differ among small-scale living facilities and regular psychogeriatric wards. These differences may limit research into effects and feasibility of various types of dementia care settings. Therefore, these studies should take resident characteristics into account in their design, for example by using a matching procedure.