Residents in small facilities also had a greater number of behavioral symptoms, as measured by the Neuropsychiatric Inventory (17 vs. 10). More residents living in small facilities had psychotic disorders as well (10% vs. 1%). There were no differences in mood or anxiety disorders between the two facility sizes.
Of the 39 residents with dementia in small facilities, the caregiver was slightly more likely to recognize dementia symptoms than were family members. The opposite was true for the 95 residents with dementia in large facilities.
In terms of treatment, small and large facilities were comparable in the percentage of patients considered completely treated (around 50%).
“Residents who are living in large facilities actually were more likely to have a private duty [caregiver] stay with them,” Ms. Samus said. Residents in large facilities also were more likely to undergo physical therapy. Large facilities offered more activities for residents. Small facilities were more likely to use restraints and bedrails.
“Small care providers were actually spending more than 400 minutes a day caring, supervising, or doing activities of daily living with their residents, compared with a little over 100 minutes for the large facilities,” Ms. Samus said. The difference may be partly explained by the higher likelihood of having a private-duty caregiver at large facilities.
Residents at small facilities had fewer falls per month (0.13, compared with 0.33). No difference was found in emergency department visits in the last month.
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