Quality of Life in People With Severe Dementia and Its Association With the Environment in Nursing Homes: An Observational Study

Abstract

Background and objectives: Theoretical models propose the environment as a factor influencing the quality of life (QoL) of nursing home residents with dementia. This study investigates whether the observed QoL differs depending on the type of care unit.

Research design and methods: DemenzMonitor is an exploratory, observational study involving annual data collection in German nursing homes (2012-2014). For this analysis, we selected residents with a recorded diagnosis of dementia and severe cognitive impairment. QoL was measured with the proxy assessment QUALIDEM. Four care unit types were investigated: large integrated, large segregated, small integrated, and small segregated.

Results: We did not find a significant difference between the care units. During the 2 years, the observed QoL was not affected by any of the care unit types in a statistically significant or clinically relevant manner. However, a significant interaction effect between time and care unit types was found.

Discussion and implications: Structural and organizational characteristics of care units, which in turn have implications for residents characteristics and the quality of care, may influence the QoL of residents. This may explain the interaction we observed.

Keywords: Dementia; Environment; Observational study; Quality of life; Structural characteristics.