title: Dementia care and quality of life in assisted living and nursing homes.
abstract: OBJECTIVE
  There are few empirical studies relating components of long-term care to quality of life for residents with dementia. This study relates elements of dementia care in residential care/assisted living (RC/AL) facilities and nursing homes to resident quality of life and considers the guidance this information provides for practice and policy.
  
  
  METHODS
  We used a variety of report and observational measures of the structure and process of care and 11 standardized measures of quality of life to evaluate the care for and quality of life of 421 residents with dementia in 35 RC/AL facilities and 10 nursing homes in four states. Data were collected cross sectionally on-site, and we conducted a 6-month follow-up by telephone.
  
  
  RESULTS
  Change in quality of life was better in facilities that used a specialized worker approach, trained more staff in more domains central to dementia care, and encouraged activity participation. Residents perceived their quality of life as better when staff was more involved in care planning and when staff attitudes were more favorable. Better resident-staff communication was related to higher quality of life as observed and reported by care providers. Also, more stable resident-staff assignment was related to care providers' lower quality-of-life ratings.
  
  
  CONCLUSIONS
  Improvement in resident quality of life may be achieved by improved training and deployment of staff.
authors.affiliation: Cecil G. Sheps Center for Health Services Research and the School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. Sheryl_Zimmerman@unc.edu
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.forename: Philip D
authors.initials: PD
authors.lastname: Sloane
authors.forename: Christianna S
authors.initials: CS
authors.lastname: Williams
authors.forename: Peter S
authors.initials: PS
authors.lastname: Reed
authors.forename: John S
authors.initials: JS
authors.lastname: Preisser
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Eckert
authors.forename: Malaz
authors.initials: M
authors.lastname: Boustani
authors.forename: Debra
authors.initials: D
authors.lastname: Dobbs
mesh_terms: D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D017028:Caregivers / Q000193:education; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011788:Quality of Life; D014481:United States