The study published in the Medical Journal of Australia found residents with dementia in aged-care facilities that provide a home-like model of care have a better quality of life and fewer hospitalisations than those living in more standard facilities.
The Flinders University INvestigating Services Provided in the Residential care Environment for Dementia (INSPIRED) study compared patient-reported outcomes and resource use for over 500 residents of 17 facilities across four Australian states.
In the home-like models, the staff and physical environments support resident choice and flexibility in activities, for example residents can have more involvement in domestic duties such as meal preparation, and provide access to the outdoors.
The study showed that residents of the home-like models of care were 52% less likely to be prescribed a potentially inappropriate medication (such as antipsychotics or benzodiazepines), which have been associated with adverse health effects such as falls or strokes in older adults. They also had a lower rate of hospitalisation admissions and emergency department presentations, after adjustments for other differences were taken into account.
The study lead, Professor Maria Crotty, from the Rehabilitation, Aged and Extended Care research group at the College of Medicine and Public Health at Flinders University, says other overseas studies have demonstrated that these models of care perform better in quality of care indicators such as re-hospitalisations, catheter use and pressure ulcers.
“But ours is the first study to examine such a range of outcomes, including resident-reported quality of life, health care, medication and aged care resource use,” Professor Crotty says.
Evidence shows the physical design of the residential aged-care environment may play an important role in the well-being of residents, particularly those living with dementia. Internationally, there is a move towards providing care in facilities that feel more like a home and promote independence.
Such models of residential aged care generally have:
The INSPIRED project is funded as part of the NHMRC Cognitive Decline Partnership Centre (CDPC). This partnership includes Dementia Australia, aged care providers Helping Hand Australia, Brightwater Care Group and HammondCare, eight universities and health-care organisations.