Engagement in purposeful activities and social interactions amongst persons with dementia in special care units compared to traditional nursing homes: An observational study.

This was an observational comparison of existing settings, not a randomised trial, so it cannot show that the special care unit caused higher afternoon engagement. The special care unit sample was small (33 residents), and participation was 52% in special care units and 35% in traditional nursing homes. The special care unit targeted people with moderate dementia, so findings may not apply to people with mild or severe dementia. The special care unit was a complex bundle of design, staff training, staff presence and personalised activities, so the contribution of any single component cannot be separated. Each resident was observed once at each time point, so the study cannot show how long individual engagements lasted or how residents experienced them. Agitation and emotion were measured by observation and may be affected by variability in expression; no significant differences between settings were found. The study did not correct for multiple testing because it was exploratory. The study was supported by SeneCura, although the authors state the funder did not influence the study or outcomes.

The study was supported by SeneCura. The authors state the funder did not influence the study or its outcomes, that they were free to report unfavourable results, and that they have no conflicts of interest to report.

Do not conclude that special care units cause more engagement or better wellbeing. The study was observational, compared one specific care concept with two traditional nursing homes, and found differences only in the afternoon; agitation and emotion did not differ, and both groups spent half their time without engagement.