Author(s): Alida H.P.M. de Rooij*,Katrien G. Luijkx,Juliette Schaafsma,Peggy M.J. Emmerink,Jos M.G.A. Schols,Anja G. Declercq
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
