Structural characteristics of specialised living units for people with dementia: a cross-sectional study in German nursing homes

BACKGROUND Living units (LU) specialised for people with dementia are an important feature of nursing homes. Little is known about their structural characteristics, and an international definition is lacking. This study explored characteristics of the environment and staff from defined LU types to identify differences between them. DESIGN Cross-sectional study comparing five types of LUs. LUs were defined based on their living concept (segregated and integrated), size (small and large scale), and funding (extra funded and not extra funded). Differences were identified using descriptive statistics, Chi-Square resp. Kruskal-Wallis-Test and post-hoc analysis with Bonferroni corrections. RESULTS In total, 103 LUs from 51 nursing homes participated: 63 integrated and 40 segregated LUs; 48 integrated and 31 segregated LUs were large. Sixteen large segregated LUs were extra funded. Regarding the environment, a distinctive feature of small LUs was a higher percentage of single rooms. Small integrated LUs provided and served meals more in a homelike manner than other LUs. LUs did not differ in their interior and access for the residents to use outdoor areas. Regarding the staff, small LUs provided more staff, but they were not exclusively assigned to the LUs. Large segregated LUs with additional funding provided more registered nurses and nurses with a special qualification per resident than the other large LUs. CONCLUSION Nursing homes implemented different features in their specialised LUs. Because single room availability, homelike provision of meals, staff quantity, quality and continuity may influence residents' outcomes, it is necessary to investigate whether differences are apparent in future evaluation studies of specialised LUs for people with dementia.