Differences in dementia services and settings across place type and regions

Abstract

People with dementia have complex and unique social, environmental, and communication needs arising from impaired cognition. One response to dissatisfaction with the medical model of care in nursing homes has been the creation of more homelike and social options for care in the community. These options include community-based residential facilities and a variety of more independent senior dwellings. Staying in residential settings longer may be associated with benefits, including decreased financial burden and improved quality of life.

However, with the boundaries between these place types often less than clearly drawn, it has become increasingly difficult to anticipate the specific services and environmental features provided by each. It is also difficult to effectively match facilities to the specific needs of older persons with dementia. Even social workers responsible for placements, especially in urban areas, may not be able to visit all local residential options. To better understand these new venues for dementia care, this study explored the range of services and settings available to people with dementia in three different place types in five Wisconsin counties: nursing homes, community-based residential facilities, and independent senior housing.

Keywords

Alzheimer's disease dementia long-term care assisted living community services in-house services

References

Baltes P : The many faces of dependency in old age.New York: Cambridge University Press, 1996.

Baltes MM , Carstensen LL : Social-psychological theories and their applications to aging: From individual to collective. In Bengston VL , Warner K , Schaie KW (eds.): Handbook of Theories of Aging. New York: Springer Publishing, 1999.

Lawton MP : Forward. In Schwarz B , Brent R (eds.): Aging, autonomy, and architecture: Advances in assisted living.Baltimore, MD: Johns Hopkins University Press, 1999.

Nahemow L : The ecological theory of aging: Powell Lawton's legacy. In Rubenstein R , Moss M , Kleban M (eds.): The many dimensions of aging.New York: Springer, 2000.

Kane R , Wilson KB : Assisted living in the United States: A new paradigm for residential care for frail older persons.Washington, DC: American Association of Retired Persons, 1993.

Schwarz B , Brent R : Aging, autonomy and architecture: Advances in assisted living.Baltimore: Johns Hopkins University Press, 1999.

Maddox GL : Housing and living arrangements, a transactional perspective. In Binstock RH , George LK (eds.): Handbook of Aging and the Social Sciences.San Diego, CA: Academic Press, 2001.

National Center for Assisted Living : Planning ahead: A consumer's guide to assisted living facilities.American Healthcare Association, 2003.

Citro J , Hermanson S : Assisted Living in the United States. (Publication ID: FS62R). Washington DC: American Association of Retired Persons, 1999.

10.

National Center for Assisted Living : Facts & Trends: The Assisted Living Sourcebook 1998.Washington, DC: American Healthcare Association, 1998.

11.

Moos RH , Lemke S : Group residences for older adults.New York: Oxford University Press, 1994.

12.

Fonda SJ , Clipp EC , Maddox GL : Patterns in functioning among residents of an affordable assisted living facility. Gerontologist. 2002; 42(2): 178-187.

13.

Grayson P , Lubin B , Van Whitlock R : Comparison of depression in the community-dwelling and assisted living elderly. J Clinical Psychology.1995; 51(1): 18-21.

14.

Weisman G : Creating places for people with dementia: An action research perspective. In Schaie KW , Wahl HW , Mollenkopf M , et al. (eds.) Aging in the community: Living arrangements and mobility. New York: Springer, 2003.