Evaluation of special and traditional dementia care in nursing homes: results from a cross-sectional study in Germany.
OBJECTIVE
Two-thirds of all residents in nursing homes in Germany suffer from some type of dementia. We investigated whether or not dementia patients receiving special (segregated or partially segregated) care exhibited a better quality of life than their counterparts residing in traditional nursing homes.


METHODS
In a cross-sectional study in 28 special dementia care facilities in the city of Hamburg (admission criterion: mobile dementia patients with behaviour problems) 594 residents were compared to a group of nursing home residents with dementia (n = 573) in 11 randomly selected nursing homes who were receiving traditional integrative care. Primary features such as cognitive and functional impairment, and behaviour problems were assessed by qualified nursing staff.


RESULTS
Controlling for confounding variables, for dementia patients in special care units as compared to a reference group in traditional integrative care, the level of volunteer caregiver involvement was higher and there was more social contact to staff, fewer physical restraints, more involvement in home activities, and more frequent use of psychiatrists. There was no significant difference between the two care settings with regard to overall use of psychotropic drugs, however, residents in special dementia care used antipsychotics significantly less often and antidepressants more often.


CONCLUSIONS
Significant differences for a number of indicators of the quality of life point in favour of special dementia care. Future evaluation studies ought to examine not only the general efficacy of types of care designed especially for dementia patients but also the efficacy of the respective individual components (i.e. caregiver ratio).
Weyerer
Siegfried
S
Central Institute of Mental Health, Mannheim, Germany. siegfried.weyerer@zi-mannheim.de
Schäufele
Martina
M
Hendlmeier
Ingrid
I
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy / Q000451:nursing* / Q000523:psychology; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009732:Nursing Care / Q000145:classification / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012114:Residential Treatment / Q000379:methods* / Q000706:statistics & numerical data*; D012931:Social Environment
D000928:Antidepressive Agents; D014150:Antipsychotic Agents