Specialized dementia programs in residential care settings

The authors conducted a telephone survey in 7 states to determine the preva lence of residential care specialized dementia programs (RC-SDPs) and to id entify a sample of homes (n = 56) for more detailed study. The 56 homes wer e site visited, and data were gathered on facility administration, therapeu tic environment, and characteristics of 259 randomly selected residents. Co mparison data from 138 nursing home Special Care Units (NH-SCUs) and 1,340 of their residents were obtained from 4 studies conducted in the same 7 sta tes. RC-SDPs were smaller, provided a more homelike environment, and had a higher proportion of residents paying privately, compared with NH-SCUs. Mea n levels of cognitive and physical impairment among residents were higher i n NH-SCUs; prevalences of psychotropic medication use and problem behaviors were similar. Among RC facilities, small homes were more homelike, provide d fewer structured activities, and charged less than larger facilities. RC- SDPs include 5 types: small, independently operated homes; multiple small h omes with joint administration; larger, all-dementia facilities; SDPs opera ted within larger, exclusively RC facilities; and RC-SDPs in multilevel fac ilities.