title: Quality of life of residents with dementia in long-term care settings in the Netherlands and Belgium: design of a longitudinal comparative study in traditional nursing homes and small-scale living facilities.
abstract: BACKGROUND
  The increase in the number of people with dementia will lead to greater demand for residential care. Currently, large nursing homes are trying to transform their traditional care for residents with dementia to a more home-like approach, by developing small-scale living facilities. It is often assumed that small-scale living will improve the quality of life of residents with dementia. However, little scientific evidence is currently available to test this. The following research question is addressed in this study: Which (combination of) changes in elements affects (different dimensions of) the quality of life of elderly residents with dementia in long-term care settings over the course of one year?
  
  
  METHODS
  A longitudinal comparative study in traditional and small-scale long-term care settings, which follows a quasi-experimental design, will be carried out in Belgium and the Netherlands. To answer the research question, a model has been developed which incorporates relevant elements influencing quality of life in long-term care settings. Validated instruments will be used to evaluate the role of these elements, divided into environmental characteristics (country, type of ward, group size and nursing staff); basic personal characteristics (age, sex, cognitive decline, weight and activities of daily living); behavioural characteristics (behavioural problems and depression); behavioural interventions (use of restraints and use of psychotropic medication); and social interaction (social engagement and visiting frequency of relatives). The main outcome measure for residents in the model is quality of life. Data are collected at baseline, after six and twelve months, from residents living in either small-scale or traditional care settings.
  
  
  CONCLUSIONS
  The results of this study will provide an insight into the determinants of quality of life for people with dementia living in traditional and small-scale long-term care settings in Belgium and the Netherlands. Possible relevant strengths and weaknesses of the study are discussed in this article.
  
  
  BACKGROUND
  ISRCTN: ISRCTN23772945.
authors.affiliation: De Kievitshorst Care Center, De Wever, Beneluxlaan 101, 5042 WN, Tilburg, The Netherlands. i.d.rooij@dewever.nl
authors.forename: Alida Hpm
authors.initials: AH
authors.lastname: de Rooij
authors.forename: Katrien G
authors.initials: KG
authors.lastname: Luijkx
authors.forename: Anja G
authors.initials: AG
authors.lastname: Declercq
authors.forename: Jos Mga
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000592:standards*; D001530:Belgium / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008134:Long-Term Care / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*