Functional Status, Behaviour and Social Interaction of Residents with Dementia Living in Small-Scale and Traditional Long-Term Care Settings in the Netherlands and Belgium

Alida H.P.M De Rooij

doi:10.4172/2161-0460.1000106

Abstract

Study background: The aim of this study was to examine how residents with dementia living in small-scale and traditional long-term care settings in the Netherlands and Belgium differ in terms of activities of daily living, behavioural problems, depression, use of restraints, psychotropic medication, social engagement and visiting frequency of relatives. Methods: The study had a longitudinal design with a time interval of one year. Participants were 179 residents with dementia in Dutch small-scale (N=51) and traditional (N=51), and Belgian small-scale (N=47) and traditional (N=30) care settings. Data were obtained by professional caregivers using validated observational measurement instruments. Results: Results show few differences between residents in small-scale and traditional settings in the two countries. In the Netherlands, residents in small-scale settings were more socially engaged and better able to perform activities of daily living compared to residents in traditional settings. In Belgium, residents in small-scale settings were also better able to perform activities of daily living, and showed fewer depressive symptoms than residents in traditional settings. Over time, activities of daily living decreased in residents of both small-scale and traditional settings in both countries. Social engagement also decreased in both countries among residents in small-scale settings but remained stable among residents in traditional settings. Furthermore, behavioural problems decreased over time in traditional settings in both countries, but remained stable in small-scale settings. Conclusions: Relatively few differences were found between small-scale and traditional settings in the two countries as regards residents’ social engagement, activities of daily living, depression and behavioural problems. The assumption made in policy and practice, however, is that living in small-scale settings is better for residents with dementia. To better understand why small-scale settings may not always be more beneficial for residents compared to traditional settings, future research should examine the patterns found in this study in more depth

Highlights

Some 4.6 million people are diagnosed with dementia throughout the world every year, and the expectation is that by 2030 there will be around 63 million people suffering from dementia worldwide [1]
The aim of the present study was to fill this gap by examining the effect of living in a small-scale or traditional long-term care setting on functional status, behaviour and social interaction of people with dementia
We examined whether and how residents in small-scale and traditional settings differ in functional status and in terms of behavioural characteristics, behavioural interventions and social interaction

Summary

Introduction

Some 4.6 million people are diagnosed with dementia throughout the world every year, and the expectation is that by 2030 there will be around 63 million people suffering from dementia worldwide [1]. Whereas in traditional residential settings, the institutional rhythm is mainly determined by the logistics of medical and nursing care [6]. This new approach aims to enable residents to continue the way of living they were used to and to offer them possibilities for social participation. For this reason, in many countries with a long history of nursing home care, traditional, largescale nursing homes are currently trying to transform their hospitallike care environments into more normalized and person-centred settings. Many newly developed long-term care settings for older persons with dementia are trying to put this new approach into practice by creating small-scale living facilities [7,8,9]

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