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The domus philosophy: A comparative evaluation of a new approach to residential care for the demented elderly
Abstract
This study reports a cross‐sectional comparison between three continuing care facilities for severely disturbed elderly demented people: two mental hospital psychogeriatric wards and a unit run according to the domus philosophy of care. The domus was characterized by greater expectations for residents' functioning, policy choice, resident control and availability of social and recreational activities. The level of staffing was higher on the domus than on the two wards. The residents on the three settings were broadly comparable with regard to age, diagnosis, length of stay, objectively assessed cognitive impairment and depression, but the domus residents were rated by the staff as less disabled in self‐care tasks, orientation and communication. Direct non‐participant observation using the Short Observation Method demonstrated significantly higher levels of activities and staff‐resident interaction on the domus compared to the hospital wards. There were no differences between the settings with regard to staff absenteeism, job turnover or psychological impairment, but the domus staff expressed higher levels of job satisfaction. These findings are discussed in the context of the limitations of study design and method.
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Two studies showed a small effect size or a significant p value indicating more anxiety in the SCU group compared to the n-SCU group.
“In 2 other studies, a small effect size [34] and a significant p value were found [26], indicating more anxiety in the SCU group compared to the n-SCU group.”
From Special Care Units and Traditional Care in Dementia: Relationship with Behavior, Cognition, Functional Status and Quality of Life - A Review (2013) · cites this paper as [26]
Deviant behaviors such as delusions, hallucinations, euphoria, apathy, disinhibition and aberrant motor behavior were significantly more prevalent in the SCU group compared to the n-SCU group.
“Deviant behavior such as delusions, hallucinations, euphoria, apathy, disinhibition and aberrant motor behavior were significantly more prevalent in the SCU group compared to the n-SCU group [26].”
From Special Care Units and Traditional Care in Dementia: Relationship with Behavior, Cognition, Functional Status and Quality of Life - A Review (2013) · cites this paper as [26]
Patient characteristics between SCUs and n-SCUs can be distinct due to differences in patient allocation.
“Furthermore, it seems that the patient characteristics between SCUs and n-SCUs can be distinct due to differences in patient allocation [26].”
From Special Care Units and Traditional Care in Dementia: Relationship with Behavior, Cognition, Functional Status and Quality of Life - A Review (2013) · cites this paper as [26]
In most of the studies, all patients were suffering from dementia; however, in 2 studies, only 60 and 75% of the subjects, respectively, suffered from dementia, while the other patients were not cognitively impaired.
“In most of the studies, all patients were suffering from dementia. However, in 2 studies, only 60 and 75% of the subjects, respectively, suffered from dementia, while the other patients were not cognitively impaired [26,33].”
From Special Care Units and Traditional Care in Dementia: Relationship with Behavior, Cognition, Functional Status and Quality of Life - A Review (2013) · cites this paper as [26]
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Research works printed but not linked: 16
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Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589
Metadata
- Authors
- Lindesay, J., Briggs, K., Lawes, M., MacDonald, A., & Herzberg, J.
- Affiliations
- Guy's Hospital (GB)
- ORCID
- MacDonald, Alastair
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 1991-10
- Volume
- 6
- Issue
- 10
- Pages
- 727-736
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W2115505897
- Cited by
- 61
- References
- 0
- Citations by year
- 2024: 5 · 2023: 1 · 2020: 1 · 2016: 1 · 2015: 1 · 2013: 4
- FWCI
- 20.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- Funders
- Gatsby Charitable Foundation
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- residential care for the elderly, dementia, psychogeriatric ward, staff-resident interaction, staffing levels, staff job satisfaction, orientation, cognitive impairment, depression
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