Rebecca Palm1, Diana Trutschel2, Michael Simon3, Sabine Bartholomeyczik4, Bernhard Holle5. 1. German Center for Neurodegenerative Diseases (DZNE) Site Witten, Witten, Germany; Department of Health, School of Nursing Science, University Witten/Herdecke, Witten, Germany. Electronic address: rebecca.palm@dzne.de. 2. German Center for Neurodegenerative Diseases (DZNE) Site Witten, Witten, Germany; Martin-Luther University Halle/Wittenberg, Institute of Informatics, Halle/Saale, Germany. 3. Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland; Nursing and Midwifery Research Unit, Inselspital Bern University Hospital, Bern, Switzerland. 4. Department of Health, School of Nursing Science, University Witten/Herdecke, Witten, Germany. 5. German Center for Neurodegenerative Diseases (DZNE) Site Witten, Witten, Germany; Department of Health, School of Nursing Science, University Witten/Herdecke, Witten, Germany.
Abstract
OBJECTIVES: To investigate differences in the provision and performance of case conferences for people with dementia between dementia special care units (DSCUs) and traditional care units (TCUs) in nursing homes. Because DSCUs employ more staff, we expect the likelihood of the provision of case conferences to be higher in DSCUs. DESIGN: Observational cross-sectional study. Residents from DSCUs and TCUs were compared using genetic propensity score matching over all of the observed potential covariates, including the characteristics that served as admission criteria for DSCUs. Because of the multisite structure of the data, clustering was accounted for with a generalized mixed model. SETTING: DSCUs are defined as units within nursing homes that offer care exclusively to residents with dementia and that charge higher rates for the specialized care provided. TCUs are defined as care units for residents with and without dementia. PARTICIPANTS: A matched sample was drawn out of a convenience sample of 1808 residents from 51 nursing homes. It consisted of 264 residents from 16 DSCUs and 264 residents from 48 TCUs. INTERVENTIONS: None. MEASUREMENTS: Data regarding the provision of case conferences were collected by the nurses using the Dementia Care Questionnaire. Other collected data included challenging behavior (Neuropsychiatric Inventory Questionnaire), mobility (Physical Self-Maintenance Scale), cognitive impairment (Dementia Screening Scale), and sociodemographic information. RESULTS: In the DSCU group, case conferences were provided to 91% (n = 224) of the residents; in the TCU group, 82.5% (n = 203) received a case conference. After adjusting for clustering, no significant difference between DSCUs and non-DSCUs was found. The topic "challenging behaviors" was discussed more often in case conferences in TCUs. CONCLUSIONS: Case conferences are a widespread intervention in German nursing homes, including both DSCUs and TCUs. The provision of a case conference is not a special feature of DSCUs.
OBJECTIVES: To investigate differences in the provision and performance of case conferences for people with dementia between dementia special care units (DSCUs) and traditional care units (TCUs) in nursing homes. Because DSCUs employ more staff, we expect the likelihood of the provision of case conferences to be higher in DSCUs. DESIGN: Observational cross-sectional study. Residents from DSCUs and TCUs were compared using genetic propensity score matching over all of the observed potential covariates, including the characteristics that served as admission criteria for DSCUs. Because of the multisite structure of the data, clustering was accounted for with a generalized mixed model. SETTING: DSCUs are defined as units within nursing homes that offer care exclusively to residents with dementia and that charge higher rates for the specialized care provided. TCUs are defined as care units for residents with and without dementia. PARTICIPANTS: A matched sample was drawn out of a convenience sample of 1808 residents from 51 nursing homes. It consisted of 264 residents from 16 DSCUs and 264 residents from 48 TCUs. INTERVENTIONS: None. MEASUREMENTS: Data regarding the provision of case conferences were collected by the nurses using the Dementia Care Questionnaire. Other collected data included challenging behavior (Neuropsychiatric Inventory Questionnaire), mobility (Physical Self-Maintenance Scale), cognitive impairment (Dementia Screening Scale), and sociodemographic information. RESULTS: In the DSCU group, case conferences were provided to 91% (n = 224) of the residents; in the TCU group, 82.5% (n = 203) received a case conference. After adjusting for clustering, no significant difference between DSCUs and non-DSCUs was found. The topic "challenging behaviors" was discussed more often in case conferences in TCUs. CONCLUSIONS: Case conferences are a widespread intervention in German nursing homes, including both DSCUs and TCUs. The provision of a case conference is not a special feature of DSCUs.
Authors: Rebecca Palm; Saskia Jünger; Sven Reuther; Christian G G Schwab; Martin N Dichter; Bernhard Holle; Margareta Halek Journal: BMC Geriatr Date: 2016-04-05 Impact factor: 3.921