Nursing Homes with Dementia Special Care Units Provide Better Quality of Care

October 18, 2018

Around 750,000 individuals in nursing homes in the United States have a diagnosis of dementia, constituting 50 percent of long‐stay residents. Between 30 and 40 percent of adults across the nation with dementia reside in nursing homes, and approximately 70 percent of Americans with dementia will die in a nursing home. These high statistics beg the question- is quality better for dementia patients in a nursing home with a specialized unit focusing on their care? 

In a study published in Health Services Research, former HCP post-doctoral fellow Nina Joyce, PhD, professor of health economics Thomas G. McGuire, PhD, and professor of health care policy David Grabowski, PhD, along with colleagues, assessed whether admission to a nursing home with a dementia special care unit improved quality.

Dementia special care units are generally designed to provide a supportive social and physical environment for older adults with dementia. Beds in these special care units make up 4.5 percent of all nursing home beds, and are the most common form of special care units in nursing homes. However, although these make up 72 percent of all special care beds, their effect on quality of care is unclear.

By examining data from national resident-level assessments, Medicare claims, and provider-level data from 2005-2010 and using a model to address selection to a nursing home with a dementia special care unit, the study team found that admission to a nursing home with a dementia special care unit led to better quality. Specifically, admission to a facility with a special care unit reduced inappropriate antipsychotic use, physical restraints, pressure ulcers, feeding tubes, and hospitalizations.

This study found that nursing home facilities with a dementia special care unit provide better quality of care as measured by several validated quality indicators. The team suggests that policies that promote the expansion and use of dementia special care units may benefit the aging population.