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Kleinschalig wonen voor ouderen met dementie: de invloed op bewoners, mantelzorgers en medewerkers

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Tijdschrift voor Gerontologie en Geriatrie

Small-scale, homelike care environments for people with dementia: effects on residents, family caregivers and nursing staff

Institutional dementia care is increasingly directed towards small-scale and homelike care environments, in The Netherlands as well as abroad. In these facilities, a small number of residents, usually six to eight, live together, and normal daily household activities and social participation are emphasized. In a quasi-experimental study, we studied the effects of small-scale, homelike care environments on residents (n = 259), family caregivers (n = 206) and nursing staff (n = 305). We compared two types of institutional nursing care during a 1 year period (baseline assessment and follow-up measurements at 6 and 12 months): (28) small-scale, homelike care environments and (21) psychogeriatric wards in traditional nursing homes. A matching procedure was applied to increase comparability of residents at baseline regarding functional status and cognition. This study was unable to demonstrate convincing overall effects of small-scale, homelike care facilities. On our primary outcome measures, such as quality of life and behaviour of residents and job satisfaction and motivation of nursing staff, no differences were found with traditional nursing homes. We conclude that small-scale, homelike care environments are not necessarily a better care environment than regular nursing homes and other types of living arrangements should be considered carefully. This provides opportunities for residents and their family caregivers to make a choice which care facility suits their wishes and beliefs best.

Samenvatting

De verpleeghuiszorg voor ouderen met dementie zet sterk in op een ontwikkeling naar kleinschalige woonvormen, zowel nationaal als internationaal. In kleinschalige woonvormen woont een beperkt aantal ouderen, in Nederland doorgaans zes tot acht personen, samen en wordt er zoveel mogelijk gestreefd naar een situatie zoals thuis. In een quasi-experimentele studie zijn de effecten van kleinschalige woonvormen onderzocht op bewoners (n = 259), mantelzorgers (n = 206) en verzorgenden (n = 305). Gedurende één jaar (nulmeting en vervolgmetingen na zes en 12 maanden) zijn hierbij twee typen verpleeghuiszorg met elkaar vergeleken: 28 kleinschalige woonvormen en 21 psychogeriatrische afdelingen in gewone verpleeghuizen. Matching werd toegepast om de vergelijkbaarheid van bewoners wat betreft cognitie en functionele status bij aanvang van de studie te vergroten. Het huidige onderzoek toont een genuanceerd beeld van kleinschalige woonvormen. Op de belangrijkste uitkomstmaten, zoals kwaliteit van leven en gedrag van bewoners en arbeidstevredenheid en –motivatie van verzorgenden, werden geen significante verschillen gevonden in vergelijking met gewone verpleegafdelingen. Deze uitkomsten geven aan dat kleinschalige woonvormen niet automatisch betere voorzieningen zijn dan gewone verpleeghuiszorg. Een volledige overgang naar kleinschalige woonvormen is daarom niet vanzelfsprekend. Gezien de heterogeniteit van de doelgroep is aanbevolen door middel van diversiteit keuzemogelijkheden te bieden voor mensen met dementie en hun naasten.

Dit artikel is een bewerking van eerder uitgebrachte Engelstalige publicaties.1 – 3

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Authors and Affiliations

  1. Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

    H. Verbeek & S. M. G. Zwakhalen

  2. CAPRHI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

    H. Verbeek, S. M. G. Zwakhalen, E. van Rossum, G. I. J. M. Kempen & J. P. H. Hamers

  3. Lectoraat Autonomie en Participatie van Chronisch Zieken, Zuyd Hogeschool, Heerlen, The Netherlands

    E. van Rossum

  4. Senior onderzoeker, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

    E. van Rossum

  5. Hoogleraar Sociale Gerontologie, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

    G. I. J. M. Kempen

  6. Hoogleraar Ouderenzorg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

    J. P. H. Hamers

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  1. H. Verbeek
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  2. S. M. G. Zwakhalen
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  3. E. van Rossum
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  4. G. I. J. M. Kempen
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  5. J. P. H. Hamers
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Correspondence to H. Verbeek.

Additional information

In dit artikel wordt met de term verzorgenden alle medewerkers (verzorgenden en verpleegkundigen) bedoeld die in de dagelijkse verpleeghuiszorg werken (niveau 1 tot en met 5).

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Verbeek, H., Zwakhalen, S.M.G., van Rossum, E. et al. Kleinschalig wonen voor ouderen met dementie: de invloed op bewoners, mantelzorgers en medewerkers. Tijdschr Gerontol Geriatr 44, 261–271 (2013). https://doi.org/10.1007/s12439-013-0044-2

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  • DOI: https://doi.org/10.1007/s12439-013-0044-2

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