Home again: small houses for individuals with cognitive impairment.

The small house model of elder care emphasizes deinstitutionalization as a strategy to reduce the negative outcomes associated with nursing home care. The small house changes the philosophy, architecture, and organizational design of the institution and has been associated with higher quality of life and good quality of care. The intended benefits to individuals with cognitive impairment include better staff understanding of dementia care, improved physical environment, and safe, familiar patterns of everyday living. Initial research has been conducted, and additional research is underway to determine whether the outcomes match the intentions.