Mailbox Response

The question was submitted 29/10/2007

Subject: Dementia Specific Care

I had to move my parents to another facility with four weeks notice, as their facility was closing. I felt pressured to take a placement which I felt was not good for my parents well being. Firstly, they would not be in the same room, secondly, it is a dementia specific facility.
Mum has alzheimers and dad has frontal lobe dementia.
I worked hard to get them into a place where they would be stimulated by people from all backgrounds and illnesses. I feel that placing them in a dementia specific facility will accelerate their condition.
I don't know whether my concern is for them, or whether I am the one who feels uncomfortable.
What are the findings or research into the benefits or disadvantages of being in a dementia specific facility?

Answer from DementiaNet

There is no data that would prove the benefits of one type of nursing home versus another. The dementia-specific hostels and nursing homes evolved in the recognition that better care might be able to be given to these patients in a specialised environment. Generally speaking the cost of providing a dementia-specific facility is greater than a normal facility and hence the scarcity of these.

Their theoretical advantage is that the focus of care is built around dementia and hence the skill and training for staff tend to reflect this more. Staff who are recruited to such a facility will generally have an interest or passion and hence likely a greater competence in managing people with dementia. Ultimately, what will determine the success of a residential facility will hinge largely around the commitment and skill of the staff.

In a general nursing home, the skill mix of staff tends to reflect the more diversified resident profile. Many staff are less able or interested to manage some of the more challenging aspects of dementia care. This may not have been the case in the place your parents were at but is a general observation.

Whether your parents would benefit by the mix of residents from a facility that has non demented patients is difficult to answer. However, on probability, they are less likely to be concerned by the company than the family and other visitors. Provided the person with dementia feels safe and cared for and that the other patients are not causing stress then it would not matter to them who the other residents are. If, however, one or more of the residents has disruptive behaviour which can occur in people with dementia, this of course can be stressful for all concerned - the residents, the staff and the family. This scenario can occur just as readily in a more general type of nursing home where the skill mix of the staff may not be as great to cope with it and hence the impact greater for all concerned. In a dementia-specific facility hopefully challenging behaviour will be better managed, staff supported and educated accordingly.

Therefore in summary, given the reality of the circumstances, it probably is the best outcome for your parents to be in a dementia-specific facility. Settling in can be quite difficult irrespective of where they go and might take many weeks. Therefore the role of the family is most important to spend as much time as possible in helping to facilitate this difficult transition

The answer was published on DementiaNet 05/11/2007