+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study



Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study



International Journal of Nursing Studies 49(8): 931-940



The number of people living with dementia worldwide is increasing, resulting in a need for more residential care. In response to criticism of the traditional medical approach to residential dementia care, many large nursing homes are transforming their traditional care facilities into more home-like small-scale living facilities. This study examined the assumed benefits of small-scale living for residents with dementia, compared to traditional long-term care in the Netherlands and Belgium. The primary outcome was quality of life, divided into nine different domains. The study had a longitudinal design within a one-year time interval. Five long-term care settings in the Netherlands and Belgium containing four traditional and twelve small-scale living units participated in the study. Data were obtained from 179 residents with dementia (age>65 years) (Dutch small-scale N=51, traditional N=51, Belgian small-scale N=47, traditional N=30). Nurses and nursing assistants were trained to fill in the questionnaires. In the Dutch sample, residents in small-scale settings had higher mean scores on 'social relations', 'positive affect', and 'having something to do' than residents in traditional settings. Moreover, mean scores on 'caregiver relation' and 'negative affect' remained stable over time among residents in small-scale settings, but decreased in traditional settings. These differences could not be explained by differences in behavioural characteristics, behavioural interventions, or social interaction. In the Belgian sample, fewer differences were found between traditional and small-scale settings. Nevertheless, residents in small-scale settings were reported to experience less 'negative affect' than those in traditional settings, which could be explained by differences in depression. Over time, however, residents 'felt more at home' in traditional settings, whereas no such increase was found for small-scale settings. Moreover, the mean quality of life scores on 'restless behaviour', 'having something to do' and 'social relations' decreased in small-scale settings, but remained stable in traditional settings. Both small-scale and traditional settings appear to have beneficial effects on different domains of quality of life of residents with dementia. Future research should focus more on the quality and content of the care provided, than on the effects of the scale and design of the environment in long-term care settings.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055310865

Download citation: RISBibTeXText

PMID: 22425065

DOI: 10.1016/j.ijnurstu.2012.02.007


Related references

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. Bmc Geriatrics 11: 20, 2012

Family caregiver perspectives on social relations of elderly residents with dementia in small-scale versus traditional long-term care settings in the Netherlands and Belgium. Journal of Clinical Nursing 21(21-22): 3106-3116, 2013

Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality of dying for patients with advanced dementia in long-term care institutions. Palliative Medicine 32(3): 613-621, 2018

Effects of small-scale, home-like facilities in dementia care on residents' behavior, and use of physical restraints and psychotropic drugs: a quasi-experimental study. International Psychogeriatrics 26(4): 657-668, 2015

Professional caregivers' mental health problems and burnout in small-scale and traditional long term care settings for elderly people with dementia in the Netherlands and Belgium. Journal of the American Medical Directors Association 13(5): 486.E7-11, 2012

Professional Caregivers’ Mental Health Problems and Burnout in Small-Scale and Traditional Long-Term Care Settings for Elderly People With Dementia in The Netherlands and Belgium. 2012

Professional Caregivers’ Mental Health Problems and Burnout in Small-Scale and Traditional Long Term Care Settings for Elderly People With Dementia in The Netherlands and Belgium. Journal of the American Medical Directors Association 13(5): 486.e7-486.e11, 2012

The effects of dementia care mapping on nursing home residents' quality of life and staff attitudes: design of the quasi-experimental study Leben-QD II. Bmc Geriatrics 13: 53, 2014

AwareCare: a pilot randomized controlled trial of an awareness-based staff training intervention to improve quality of life for residents with severe dementia in long-term care settings. International Psychogeriatrics 25(1): 128-139, 2013

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study. Dementia and Geriatric Cognitive Disorders 42(3-4): 186-197, 2016

Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study. International Psychogeriatrics 27(10): 1739-1747, 2016

Dementia care mapping: effects on residents' quality of life and challenging behavior in German nursing homes. A quasi-experimental trial. International Psychogeriatrics 27(11): 1875-1892, 2016

Evaluating the quality of life of long-term care residents with dementia. Gerontologist 45 Spec No 1(1): 37-49, 2005

Quality of end-of-life care of long-term nursing home residents with and without dementia. Journal of the American Geriatrics Society 61(7): 1066-1073, 2013

Psychometric properties of instruments to measure the quality of end-of-life care and dying for long-term care residents with dementia. Quality of Life Research 21(4): 671-684, 2012