Kleinschalige zorg, grote verschillen. - Wonen met dementie

Summary
Small scale housing for the elderly suffering from dementia is a form of care that is
alternative for the care in nursing homes. In the Netherlands small scale housing originated in
1986 from the experience-directed-approach “warm care”. The transformation to the smaller
scale was initiated both from the politics as well as from the care sector itself. It has not been
until the past 5 years that the small scale housing for the elderly suffering from dementia
developed a great deal. In spite of that development, in 2003 there were only 1346 people
with dementia living in a small scale house while 33.000 people with dementia were living in
a nursing home.
This final project attends to the small scale housing for the elderly suffering from dementia.
The project exists of a preliminary investigation and a secondary investigation.
The leading question in the preliminary investigation was: Are the characteristics of small
scale housing for the elderly suffering from dementia, as formulated by the Trimbosinstitution,
consistent with the practise and which factors influence the way small scale
housing for the elderly suffering from dementia is given shape to in practise?
By visiting 8 different projects of small scale housing and interviewing directors and
managers of the 8 projects, an image arose of how the small scale housing is given shape to
in the practise.
The preliminary investigation made clear that the ever-changing rules and regulation, the
financing of care and different factors from the environment are important factors that
influence the way small scale housing for the elderly suffering from dementia is given shape
to. Personal convictions of founders and managers of small scale projects is the most
important factor because it influences the way of dealing with the rules en regulation and the
environmental factors. This results in the situation that no project of small scale housing is
similar to another.
Small scale housing and small scale caring for people suffering from dementia have a lot of
different appearances. There are for example communes of 5 residents living in a house in a
residential area; and there are communes of 11 residents living on a ward in a large nursing
home. There is no consensus in what a small scale house should look like.
Survey of the literature and the results of the preliminary investigation made clear that the
different appearances in small scale housing lead to different levels of small scale.
The leading question in the secondary investigation was: Which similarities and differences
exist between the care in a project of small scale housing for people suffering from dementia
and the small scale care given in a psychogeriatric ward of a modern nursing home?
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