Measuring social integration among residents in a dementia special care unit versus traditional nursing home: A pilot study

Abstract

The physical and mental health of older adults with dementia is affected by levels of social integration. The development of dementia special care units (D-SCU) arose, in part, to facilitate more meaningful social interactions among residents implying greater social integration of D-SCU residents as compared to residents in a traditional nursing home. But, it is unknown whether D-SCU residents are receiving equal or greater benefits from living on a segregated unit intended to enhance their social environment and integration through both design and staff involvement. The purpose of this study was to pilot test a comprehensive objective assessment to measure social integration among nursing home residents with dementia and to compare levels of integration of residents living on a dementia special care unit (D-SCU) to those living in a traditional nursing home (TNH). A total of 29 residents participated (15 D-SCU and 14 TNH) and data were gathered from medical charts, visitor logs, and through direct observations. Over 1,700 interactions were recorded during 143 hours of observation. Specifically, the location, context, type, quantity, and quality of residents’ interactions were recorded. Overall, the majority of resident interactions were verbal and initiated by staff. Interactions were social in context, and occurred in public areas, such as the common room with a large screen TV. Average interactions lasted less than one minute and did not change the resident’s affect. Residents spent between 10% and 17% of their time interacting with other people on average. D-SCU staff were significantly more likely to initiate interactions with residents than TNH staff. D-SCU residents also experienced more interactions in the afternoons and expressed more pleasure and anxiety than residents in the TNH. This study helps to lay the groundwork necessary to comprehensively and objectively measure social integration among people with dementia in order to evaluate care environments.

Family member eating assistance and food intake in long‐term care: A secondary data analysis of the M3 Study

“…In their retrospective study, Palese, Grassetti, et al (2019) reported that increased levels of dependence in feeding were associated with larger LTC care units. Dementia care units are typically home to fewer residents compared with general care units, with care staff specially trained in dementia care approaches which may better support those residents who face eating challenges and thus can address issues surrounding nutritional intake (Abbott et al, 2017). As well, care philosophies and home‐like environments in specialized dementia care settings may also encourage more meaningful family involvement (Robinson et al, 2010).…”

Nursing home residents with advanced dementia and persistent vocalisations: Observations of surrounding context

“…A study on social integration and interactions among NH residents with dementia found that participants spent only a small portion of their day (10%-16%) interacting with other people (Abbott, Sefcik, & Van Haitsma, 2017). Social interactions were most common in shared areas, such as the television room (30%) and activity rooms (23%).…”

The impact of street clothes among caregivers on residents with dementia in special care units: The STRECLO study

“…Therefore, investigations that do not utilise dementia‐specific scales should be conducted to examine to what extend wearing street clothes positively affects the everyday life of residents, and hence, the nature of relationships they have with caregivers and other residents. Residents in SCUs have higher cognitive limitations that represent an obstacle to self‐reported measures but not to observational measures (Abbott, Sefcik, & Van Haitsma, 2017), and more specifically, video‐recorded sessions should lead to improved assessment in this population (Algar, Woods, & Windle, 2016).…”