Quality outcomes in group home dementia care for adults with intellectual disabilities.

BACKGROUND: Dementia, as a public health challenge, is a phenomenon vexing many care organisations providing specialised residential and family supports for older adults with intellectual disabilities. With increasing survivorship to ages when risk is greatest, expectations are that many more adults in service will present with cognitive decline and diagnosed dementia as they grow older. As persons with dementia present with new needs, there is often a call for a reorientation of services. With respect to residential supports, agencies may need to adapt current methods of care, with particular attention to providing care in small group homes. However, dementia-related care also must be quality care and applicable standards need to be met.
METHOD: Reviewed were relevant policy and practice organisational guidelines and applied research literature addressing components of care and service provision that are critical to quality care and that were consistent with professional practice.
RESULTS: Examined were the nuances and contributing factors of quality dementia care and it was proposed that quality of care criteria need to be universally applicable and serve as a framework for adapting extant residential environments and make them 'dementia-capable'.
CONCLUSIONS: It is proposed that efforts to evaluate dementia-related care provision with respect to quality need to consider quality of care provision components such as (1) clinically relevant early and periodic assessment; (2) functional modifications in the living setting; (3) constructive staff education and functionality for stage-adapted care; and (4) flexible long-term services provision that recognises and plans for progression of decline and loss of function.