Beyond Labels: Nursing Home Care for Alzheimer's Disease In and Out of Special Care Units

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Abstract
To compare dementia special care units (SCUs) with their non-SCU counterparts in terms of unit and facility characteristics. Cross-sectional telephone survey and secondary database. 1247 units in 436 Minnesota nursing homes. Specialized dementia care practices (e.g., staffing, environmental design and programming features) and organizational characteristics (e.g., size, geographic location, type of ownership, proportion dementia, case-mix and percentage Medicaid). Comparing unit level data for all units in 436 facilities, we found that 75 SCUs offered more dementia-specific features than did the 1122 units not designated as SCUs, but most units offered some dementia-specific features similar to those of SCUs. The designation of SCU did not automatically translate into richer or more tailored services for dementia compared with units without the designation. Facilities with designated SCUs are more likely to be rural, larger and divided into more units, have a higher proportion of residents with dementia, and have fewer residents at higher levels of acuity. Presence of a SCU in a facility may be related to care of dementia in the rest of the nursing home in complex ways; some dementia-specific features were less likely to be found in regular units of nursing homes with designated SCUs.