期刊论文详细信息
International Journal of Mental Health Systems
Structural characteristics of specialised living units for people with dementia: a cross-sectional study in German nursing homes
Bernhard Holle1  Martina Roes1  Sabine Bartholomeyczik1  Rebecca Palm1 
[1] Witten/Herdecke University (UW/H), Faculty of Health, School of Nursing Science, Stockumer Str. 12, 58453 Witten, Germany
关键词: Structural characteristics;    Small-scale living unit;    Dementia special care unit;    Dementia;   
Others  :  1136069
DOI  :  10.1186/1752-4458-8-39
 received in 2014-07-02, accepted in 2014-10-12,  发布年份 2014
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【 摘 要 】

Background

Living units (LU) specialised for people with dementia are an important feature of nursing homes. Little is known about their structural characteristics, and an international definition is lacking. This study explored characteristics of the environment and staff from defined LU types to identify differences between them.

Design

Cross-sectional study comparing five types of LUs. LUs were defined based on their living concept (segregated and integrated), size (small and large scale), and funding (extra funded and not extra funded). Differences were identified using descriptive statistics, Chi-Square resp. Kruskal-Wallis-Test and post-hoc analysis with Bonferroni corrections.

Results

In total, 103 LUs from 51 nursing homes participated: 63 integrated and 40 segregated LUs; 48 integrated and 31 segregated LUs were large. Sixteen large segregated LUs were extra funded. Regarding the environment, a distinctive feature of small LUs was a higher percentage of single rooms. Small integrated LUs provided and served meals more in a homelike manner than other LUs. LUs did not differ in their interior and access for the residents to use outdoor areas. Regarding the staff, small LUs provided more staff, but they were not exclusively assigned to the LUs. Large segregated LUs with additional funding provided more registered nurses and nurses with a special qualification per resident than the other large LUs.

Conclusion

Nursing homes implemented different features in their specialised LUs. Because single room availability, homelike provision of meals, staff quantity, quality and continuity may influence residents’ outcomes, it is necessary to investigate whether differences are apparent in future evaluation studies of specialised LUs for people with dementia.

【 授权许可】

   
2014 Palm et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Alzheimer‘s Disease International: World Alzheimer Report 2013. Journey of Caring. An Analysis of Long-Term Care For Dementia. London: Health Service and Population Research Department; 2013.
  • [2]Brodaty H, Connors MH, Xu J, Woodward M, Ames D: Predictors of institutionalization in dementia: a three year longitudinal study. J Alzheimers Dis 2014, 40(1):221-226.
  • [3]World Health Care Oganization (WHO): Dementia. A Public Health Priority. Genf: Department of Mental Health and Substance Abuse; 2012.
  • [4]Dutch Ministry of Health Welfare and Sports: Dutch Dementia Plan. The Hague; 2008. http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/Netherlands#fragment-1 webcite
  • [5]Norwegian Ministry of Health and Care Services: Dementia Plan 2015. Oslo; 2008. http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/Norway#fragment-1 webcite
  • [6]Cahill S, O‘Shea E, Pierce M: Creating Excellence in Dementia Care. A Research Review for Ireland’s National Dementia Strategy. Dublin/Galway: School of Social Work and Social Policy, Trinity College, Dublin; Irish Centre for Social Gerontology, National University of Ireland, Galway; 2012.
  • [7]Deutsche Alzheimer Gesellschaft EV: Vergesst die Demenzkranken nicht! Forderungen der Deutschen Alzheimer Gesellschaft [Don‘t Forget People with Dementia. Claims of the German Alzheimer Society]. Berlin: Deutsche Alzheimer Gesellschaft e.V; 2007.
  • [8]Bundesministerium für Gesundheit (BMG): Rahmenempfehlungen Zum Umgang Mit Herausforderndem Verhalten Bei Menschen Mit Demenz In Der Stationären Altenhilfe [Guidelines For Handling Challenging Behavior In People With Dementia Living In Nursing Homes]. Berlin: Bundesministerium für Gesundheit (BMG) [Federal Ministry of Health]; 2007.
  • [9]Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e.V: Grundsatzstellungnahme: Pflege Und Betreuung Von Menschen Mit Demenz In Stationären Einrichtungen [Principal Report: Care For People With Dementia In Nursing Homes]. Essen: Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen [Medical Advisory Services of the statutory health insurance]; 2009.
  • [10]Leon J, Cheng CK, Alvarez R: Trends in special care: changes in SCU from 1991 to 1995 (1995/96 TSC). J Ment Health 1997, 3(2):149-168.
  • [11]Ohta RJ, Ohta BM: Special units for Alzheimer’s disease patients: a critical look. Gerontologist 1988, 28(6):803-808.
  • [12]Schneekloth U, Törne I: Entwicklungstrends in der stationären Versorgung - Ergebnisse der Infratest-Repräsentativerhebung [Development Trends in Long Term Care-Results of A Representative Infratest Survey]. In Pflegebedarf Und Versorgungssituation Bei Älteren Menschen In Heimen. Edited by Schneekloth U, Wahl HW. Stuttgart: Kohlhammer Verlag; 2009:43-157.
  • [13]U.S. Congress (Office Technology Assessment): Special Care Units for People with Alzheimer's and Other Dementias: Consumer Education, Research, Regulatory, and Reimbursement Issues. OTA-H-543. Washington D.C.: U.S. Government Printing Office; 1992.
  • [14]Dürrmann P (Ed): Besondere stationäre Dementenbetreuung II. Konzepte, Kosten, Konsequenzen [Specialised Dementia care. Concepts, Costs, Consequences]. Hannover: Vincentz Network; 2005.
  • [15]Planer K: Haus- und Wohngemeinschaften. Neue Pflegekonzepte Für inovative Versorgungsformen [Living Goups. New Care Concepts for Innovative Care. ]. Bern: Verlag Hans Huber, Hogrefe AG; 2010.
  • [16]Maslow KOM: Review of a decade of dementia special care unit research: lessons learned and future directions. Alzheimers Care Q 2001, 2:10-16.
  • [17]Weyerer S, Schäufele M, Hendlmeier I: Evaluation of special and traditional dementia care in nursing homes: results from a cross-sectional study in Germany. Int J Geriatr Psychiatry 2010, 25(11):1159-1167.
  • [18]Crespo M, Hornillos C, Gomez MM: Dementia special care units: a comparison with standard units regarding residents’ profile and care features. Int Psychogeriatr 2013, 25(12):2023-2031.
  • [19]Verbeek H, van Rossum E, Zwakhalen SM, Kempen GI, Hamers JP: Small, homelike care environments for older people with dementia: a literature review. Int Psychogeriatr 2009, 21(2):252-264.
  • [20]de Rooij AH, Luijkx KG, Schaafsma J, Declercq AG, Emmerink PM, Schols JM: Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study. Int J Nurs Stud 2012, 49(8):931-940.
  • [21]te Boekhorst S, Depla MF, de Lange J, Pot AM, Eefsting JA: The effects of group living homes on older people with dementia: a comparison with traditional nursing home care. Int J Geriatr Psychiatry 2009, 24(9):970-978.
  • [22]Smit D, de Lange J, Willemse B, Pot AM: The relationship between small-scale care and activity involvement of residents with dementia. Int Psychogeriatr 2012, 24(5):722-732.
  • [23]Funaki Y, Kaneko F, Okamura H: Study on factors associated with changes in quality of life of demented elderly persons in group homes. Scand J Occup Ther 2005, 12(1):4-9.
  • [24]Kane RA, Lum TY, Cutler LJ, Degenholtz HB, Yu TC: Resident outcomes in small-house nursing homes: a longitudinal evaluation of the initial green house program. J Am Geriatr Soc 2007, 55(6):832-839.
  • [25]Zimmerman S, Anderson WL, Brode S, Jonas D, Lux L, Beeber AS, Watson LC, Viswanathan M, Lohr KN, Sloane PD: Systematic review: effective characteristics of nursing homes and other residential long-term care settings for people with dementia. J Am Geriatr Soc 2013, 61(8):1399-1409.
  • [26]Sloane PD, Lindeman DA, Phillips C, Moritz DJ, Koch G: Evaluating Alzheimer’s special care units: reviewing the evidence and identifying potential sources of study bias. Gerontologist 1995, 35(1):103-111.
  • [27]Palm R, Köhler K, Schwab CG, Bartholomeyczik S, Holle B: Longitudinal evaluation of dementia care in German nursing homes: the “DemenzMonitor” study protocol. BMC Geriatr 2013, 13(1):123. BioMed Central Full Text
  • [28]te Boekhorst S, Depla MF, Pot AM, de Lange J, Eefsting JA: The ideals of group living homes for people with dementia: do they practice what they preach? Int Psychogeriatr 2011, 23(9):1526-1527.
  • [29]Köhler L, Weyerer S, Schäufele M: Proxy screening tools improve the recognition of dementia in old-age homes: results of a validation study. Age Ageing 2007, 36(5):549-554.
  • [30]Fleming R, Purandare N: Long-term care for people with dementia: environmental design guidelines. Int Psychogeriatr 2010, 22(7):1084-1096.
  • [31]Verbeek H, Zwakhalen SMG, van Rossum E, Ambergen T, Kempen GIJM, Hamers JPH: Dementia care redesigned: effects of small-scale living facilities on residents, their family caregivers, and staff. J Am Med Dir Assoc 2010, 11(9):662-670.
  • [32]te Boekhorst S: Redesigning Dementia Care. An Evaluation of Small-Scale, Homelike Care Environments. Department of Health Care and Nursing Science, School for public health and primary care: Maastricht University; 2011. [PhD Thesis]
  • [33]Schmidt SG, Dichter MN, Palm R, Hasselhorn HM: Distress experienced by nurses in response to the challenging behaviour of residents - evidence from German nursing homes. J Clin Nurs 2012, 21(21–22):3134-3142.
  • [34]Donald F, Martin-Misener R, Carter N, Donald EE, Kaasalainen S, Wickson-Griffiths A, Lloyd M, Akhtar-Danesh N, DiCenso A: A systematic review of the effectiveness of advanced practice nurses in long-term care. J Adv Nurs 2013, 69(10):2148-2161.
  • [35]Backhaus R, Verbeek H, van Rossum E, Capezuti E, Hamers JP: Nurse staffing impact on quality of care in nursing homes: a systematic review of longitudinal studies. J Am Med Dir Assoc 2014, 15(6):383-393.
  • [36]Xu D, Kane RL, Shamliyan TA: Effect of nursing home characteristics on residents’ quality of life: a systematic review. Arch Gerontol Geriatr 2013, 57(2):127-142.
  • [37]Zimmerman S, Sloane PD, Williams CS, Reed PS, Preisser JS, Eckert JK, Boustani M, Dobbs D: Dementia care and quality of life in assisted living and nursing homes. Gerontologist 2005, 45 Spec No 1(1):133-146.
  • [38]Abrahamson K, Lewis T, Perkins A, Clark D, Nazir A, Arling G: The influence of cognitive impairment, special care unit placement, and nursing facility characteristics on resident quality of life. J Aging Health 2013, 25(4):574-588.
  • [39]Twigg D, Duffield C: A review of workload measures: a context for a new staffing methodology in Western Australia. Int J Nurs Stud 2009, 46(1):131-139.
  • [40]Shin JH, Bae SH: Nurse staffing, quality of care, and quality of life in US nursing homes, 1996–2011: an integrative review. J Gerontol Nurs 2012, 38(12):46-53.
  • [41]Statistisches Bundesamt: Pflegestatistik 2011. Pflege im Rahmen der Pflegeversicherung. [Care Statistics 2011. Care According to the Long Term Care Insurance.]. Wiesbaden: Statistisches Bundesamt; 2013.
  • [42]United Nations: Final report of the Ad Hoc Committee on a Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities. http://www.un.org/esa/socdev/enable/rights/ahcfinalrepe.htm webcite
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