An exploration of occupation in nursing home residents with dementia

In Ireland, the cost of dementia care in 2006 was estimated to be €400 million, or 0.7% of its gross national product. One-third of this was spent on residential care, 25% of which was paid for by direct public funding (O’Shea 2007). The prevalence of dementia is linked to increasing age and the number of the oldest old is rising, with considerable potential increases in the costs of dementia care in the next decades. It will be a major driver of costs in health care in developed countries (Wimo et al 2006), with fears about the ability of society to cope with these costs (Wimo et al 1997). Since the care of people with dementia in nursing homes is expensive, it is important for it to be evaluated and studied (Winblad et al 1999) in order to establish standards of care and value for money. Although various opinions are expressed concerning crucial design features, such as household kitchens, discrete household entrances and open plan communal rooms, these design components are not well served by empirical scientific investigation (Gitlin et al 2003, O’Malley and Croucher 2005, Calkins 2009). There is now growing research interest in evaluating the living experience of people with dementia in nursing homes (Zimmerman et al 2005, Slaughter et al 2006). However, it is complex and challenging to evaluate staff, visitor and resident interactions within residential care environments (Gilster et al 2002).