Differences in dementia services and settings across place types and regions.

People with dementia have complex and unique social, environmental, and communication needs arising from impaired cognition. One response to dissatisfaction with the medical model of care in nursing homes has been the creation of more homelike and social options for care in the community. These options include community-based residential facilities and a variety of more independent senior dwellings. Staying in residential settings longer may be associated with benefits, including decreased financial burden and improved quality of life. However, with the boundaries between these place types often less than clearly drawn, it has become increasingly difficult to anticipate the specific services and environmental features provided by each. It is also difficult to effectively match facilities to the specific needs of older persons with dementia. Even social workers responsible for placements, especially in urban areas, may not be able to visit all local residential options. To better understand these new venues for dementia care, this study explored the range of services and settings available to people with dementia in three different place types in five Wisconsin counties: nursing homes, community-based residential facilities, and independent senior housing.