Beyond the dichotomy - An empirical typology of Alzheimer's care in nursing homes

Unit-level data describing dementia care attributes in 390 units in 123 Minnesota nursing facilities were used in a two-stage analytic procedure (1) to derive a typology of unit clusters and (2) to describe similarities and differences across unit clusters in terms of dementia care attributes and other unit characteristics not used to derive the typology, Nursing units were classified with combinations of environmental, programmatic, and staff attributes into six unit clusters. Most special care units (SCUs) were in a single unit cluster (dementia units) with the most dementia care attributes and serving mostly residents with dementia. Two unit clusters (small custodial units and rehabilitation units) were composed exclusively of non-SCUs, whereas remaining unit clusters (conventional units, large undifferentiated units, and heavy care units) consisted predominantly of non-SCUs with roughly equal proportions of residents with and without dementia. The typology offers a potentially useful way of classifying dementia care in nursing homes.