Dementia special care aims to improve the quality of life of people with dementia who exhibit severe psychiatric and behavioral symptoms like agitation, delusions or aberrant motor activity. Dementia special care is often provided in designated care units of nursing homes, so called Dementia Special Care Units (DSCU). These units offer a dementia-specific activity program, the staff is specially trained and the environment is adapted to the needs of people with cognitive impairments.
The project BeStaDem aims to evaluate which aspects of DSCUs are working, for whom, and under what circumstances the outcomes intended are reached. The knowledge generated in the project will lead to a middle-range theory about contextual aspects that are needed to facilitate an effectively working DSCU and which mechanisms enhance or hinder their successful implementation. It will also give advice for whom which DSCU model may be the most beneficial.
The project is based on the realist evaluation approach by Pawson & Tilley (1997). This is a theory-driven multi-method approach that provides an in-depth exploration of causal mechanisms and their social and contextual influences (Salter & Kothari, 2014). Starting with the formulation of an initial theory on the relationship between contextual factors, underlying mechanism and their influence on outcomes, the initial theory is being tested and refined by applying different scientific methods. The theory evolves in an iterative process.
The evaluation is carried out in four sub-studies:
- BeStaDem – Experts
- BeStaDem – Rapid Realist Review
- BeStaDem – Survey study
- BeStaDem – Case studies
To prepare the data collection of the case studies, a questionnaire to assess the quality of the environment of nursing homes is translated into the German language, culturally adapted and tested (GEAT).
The developed theory will be the basis for recommendations for providers of DSCUs and policymakers to support decisions made in negotiations between nursing home providers and cost bearers and to enable an evidence-based policy of DSCUs.