Central Institute of Mental Health, Mannheim, Germany.
Int J Geriatr Psychiatry. 2010 Nov;25(11):1159-67. doi: 10.1002/gps.2455.
Two-thirds of all residents in nursing homes in Germany suffer from some type of dementia. We investigated whether or not dementia patients receiving special (segregated or partially segregated) care exhibited a better quality of life than their counterparts residing in traditional nursing homes.
In a cross-sectional study in 28 special dementia care facilities in the city of Hamburg (admission criterion: mobile dementia patients with behaviour problems) 594 residents were compared to a group of nursing home residents with dementia (n = 573) in 11 randomly selected nursing homes who were receiving traditional integrative care. Primary features such as cognitive and functional impairment, and behaviour problems were assessed by qualified nursing staff.
Controlling for confounding variables, for dementia patients in special care units as compared to a reference group in traditional integrative care, the level of volunteer caregiver involvement was higher and there was more social contact to staff, fewer physical restraints, more involvement in home activities, and more frequent use of psychiatrists. There was no significant difference between the two care settings with regard to overall use of psychotropic drugs, however, residents in special dementia care used antipsychotics significantly less often and antidepressants more often.
Significant differences for a number of indicators of the quality of life point in favour of special dementia care. Future evaluation studies ought to examine not only the general efficacy of types of care designed especially for dementia patients but also the efficacy of the respective individual components (i.e. caregiver ratio).
德国三分之二的养老院居民患有某种类型的痴呆症。我们调查了接受特殊（隔离或部分隔离）护理的痴呆症患者的生活质量是否优于居住在传统养老院的患者。
在汉堡市 28 家专门的痴呆症护理机构进行的横断面研究中（入院标准：有行为问题的活动能力痴呆症患者），将 594 名居民与 11 家随机选择的传统综合护理养老院中患有痴呆症的对照组（n = 573）进行比较。合格的护理人员评估了认知和功能障碍以及行为问题等主要特征。
在控制混杂变量的情况下，与传统综合护理中的参考组相比，特殊护理单元中的痴呆症患者的志愿者护理人员参与度更高，与工作人员的社会接触更多，身体约束更少，参与家庭活动更多，精神科医生的使用更频繁。然而，在两种护理环境下，精神药物的总体使用没有显著差异，但是，特殊痴呆症护理中的居民使用抗精神病药物的频率显著降低，而使用抗抑郁药的频率更高。
生活质量的许多指标存在显著差异，有利于特殊痴呆症护理。未来的评估研究不仅应该检查专门为痴呆症患者设计的护理类型的总体疗效，还应该检查各自的单个组成部分（即护理人员比例）的疗效。
