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Dementia Patients Seem to Benefit From Small Group Homes

FRIDAY, Sept. 16 (HealthDay News) -- People with dementia appear to be better off in small group homes rather than large nursing homes because they offer a domestic environment where patients can live as individuals, new research suggests.

And small group homes offer the added benefit of allowing the relatives of dementia patients to get involved, the researchers pointed out in the study published in the September issue of the Journal of Clinical Nursing.

"It's estimated that 80 million people worldwide will suffer from dementia by 2040," Ezra van Zadelhoff, from Maastricht University in the Netherlands, said in a journal news release. "Up until now, traditional care for people with dementia has mostly been provided in large nursing homes. However, a number of countries are increasingly providing care in small group homes, which offer a more domestic environment focusing on normal daily life."

Small group homes have already been established in the Netherlands, Sweden, Germany and Japan. In conducting the study, researchers focused on two such homes with 10 residents each, located in an urban area in the Netherlands. The smaller living units were situated on the campus of a traditional large-scale nursing home.

Inside the homes were a communal living room and kitchen. Eight residents have a private bedroom with their own furniture. The remaining 12 residents share bedrooms decorated as they would be in a traditional home. All of the residents, however, require around-the-clock care, which is provided by a full-time nursing staff experienced in geriatric care.

This nursing staff helps the residents perform general household duties and daily activities, such as cleaning, cooking, walking and exercising.

After observing the residents for 32 hours over the course of eight days and interviewing five of the residents as well as some family members and staff, the researchers found that the residents felt at home in their small group environment. Daily activities also provided the patients with stability and clarity, the study noted. The patients were also able to involve themselves in familiar activities, which helped them maintain their identity and feel more comfortable.

Relatives of the residents were treated as family, not just visitors, the researchers pointed out. They had keys to the home, visited regularly and helped with patients' personal care and chores.

The investigators also found that nurses working in the small group home were able to foster strong relationships with the residents and tailor care to their specific needs.

"The findings of our study indicate that the key to providing person-centered care for people with dementia is to enable people to be themselves and live in an environment where they and their families can get involved in normal daily activities," van Zadelhoff explained in the news release.

"However, the model is not without its problems," she added. "Nursing staff get more involved with residents and this can conflict with their clinical and professional distance. And the families in our study varied in how much they wanted to get involved in the care provided by the home, which sometimes led to tension."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about dementia.

-- Mary Elizabeth Dallas

SOURCE: Journal of Clinical Nursing, news release, Sept. 15, 2011

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