The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill

Abstract
This article reports the findings of a prospective study of the first year of operation of two residential domus units for elderly people with dementia (domus A) and chronic schizophrenia (domus B). Residents, staff and the process of care were assessed at baseline in long‐stay mental hospital wards, and at 3 months, 6 months and 12 months after the move to a domus. At 12 months, both domuses were providing more policy choice, resident control, provision for privacy and availability of social and recreational activities than a baseline psychogeriatric ward. Residents' cognitive function improved steadily over the follow‐up period in both domuses, significantly so in domus A. There was also some improvement in residents' self‐care (ADL) skills at follow‐up in both domuses. Residents' communication skills were rated as significantly improved by staff in domus A at all follow‐up assessments, and by staff in domus B at 6 months. Compared to baseline, substantially higher levels of activities and interpersonal interactions were observed at follow‐up in both domuses. There was no evidence that staff suffered from low job satisfaction or psychological impairment at either domus.