Understanding the Four Types of Dementia Care Settings: Prison, Hospital, Hotel and Home

When it comes to caring for individuals with dementia, the environment in which they receive care plays a critical role in their overall well-being. Dr. Cameron Camp, a leading expert in dementia care, has described four distinct types of care settings: prison, hospital, hotel and home. Each of these settings has its proponents who argue for their appropriateness, but most have significant drawbacks, especially when it comes to truly supporting the needs of people with dementia.

In this article, we’ll explore the pros and cons of each setting to understand why the “home” model is considered the most desirable.

Prison, Hospital, Hotel and Home

 

The Prison Model

Pros:

Proponents of the prison model argue that its rigid structure and strict routines can provide a sense of predictability and security for individuals with dementia.

The controlled environment can help reduce the confusion and anxiety that often accompany the disease.

Cons:

The prison model is highly restrictive, offering little to no personal freedom for residents. This can lead to feelings of confinement and helplessness; a loss of autonomy which can exacerbate the symptoms of dementia.

The prison-like atmosphere can be cold and impersonal, stripping individuals of their dignity and individuality. This environment fails to recognize the unique needs and preferences of each person, leading to a decrease in their quality of life.

The Hospital Model

Pros:

The hospital model is heavily focused on medical care, ensuring that individuals with dementia receive the necessary treatments and medications.

This can be particularly important for those with complex health needs.

Being in a hospital setting means that residents have immediate access to doctors, nurses, and other healthcare professionals who can respond quickly to any medical issues that arise.

Cons:

The hospital model can feel overly clinical, with an emphasis on treating the disease rather than caring for the person.

This can create an impersonal atmosphere; a clinical and sterile environment that may increase anxiety and depression in individuals with dementia.

While the focus on medical care is strong, the hospital model often overlooks the social and emotional needs of individuals with dementia.

The sterile environment can contribute to feelings of isolation and loneliness.

Prison, Hospital, Hotel and Home

The Hotel Model

Pros:

The hotel model aims to provide a high level of comfort and service, with a focus on amenities and a pleasant living environment. This can create a more luxurious and enjoyable experience for residents.

Proponents of the hotel model argue that the emphasis on customer service ensures that residents’ needs are met promptly and efficiently, which can enhance their day-to-day living experience.

Cons:

While the hotel model offers comfort and amenities, it can lack depth in terms of personalized care.

The focus on luxury and service may overshadow the need for meaningful engagement and emotional support.

The hotel-like atmosphere can feel artificial and disconnected from reality, which may not be suitable for individuals with dementia who benefit from familiarity and routine.

The emphasis on appearance over substance can lead to a lack of genuine connection and care.

Dr. Maria Montessori’s philosophy that “Everything you do for me, you take from me” is a powerful statement emphasizing the importance of fostering independence and active participation.

This concept is particularly relevant when evaluating the hotel model of care.

In the hotel model, where comfort and service are prioritized, there’s a risk that too much may be done for the individual, rather than with them.

While the environment may be luxurious and the service attentive, it can inadvertently lead to a loss of autonomy and a reduction in opportunities for the individual to engage in meaningful activities that maintain or enhance their cognitive and physical abilities.

This approach can be a significant con for the hotel model because it may diminish the person’s sense of purpose and ability to retain important life skills.

The very acts of choosing, doing, and engaging are essential for the well-being of people with dementia, as they help preserve their remaining abilities and foster a sense of dignity and independence.

The Home Model

Pros:

The home model is designed to replicate the comfort and familiarity of a real home. It emphasizes person-centered care, focusing on the individual’s preferences, routines, and history.

This approach helps maintain their identity and dignity.

By creating a warm, supportive environment that feels like home, this model encourages social interaction and emotional well-being. Individuals are more likely to feel safe, valued, and connected to those around them.

The home model allows for greater flexibility and autonomy, enabling individuals to make choices about their daily activities and routines.

This helps preserve their independence and sense of control.

Cons:

While the home model is highly desirable, it can be challenging to implement, particularly in larger care facilities. The Montessori Dementia Center can help.

It requires careful planning, a dedicated staff, and a commitment to truly understanding and meeting the needs of each individual.

Providing care in a home-like environment can be resource-intensive, requiring more personalized attention and potentially higher costs (although these are offset in the long run). This can make it difficult to maintain in some settings, but the rewards are worth it.

Click here to see ‘Overcoming the Challenges of the Home Model in Dementia Care Residences’

Each of these four care models – prison, hospital, hotel and home –  has its own set of pros and cons. But when it comes to caring for individuals with dementia, the “home” model stands out as the most beneficial.

The home model offers a person-centered approach that prioritizes the emotional and social well-being of individuals. This helps them maintain their dignity, independence, and quality of life.

While the prison, hospital, hotel and home models each have their advantages, the first three often fall short. As a result, they fail to meet the unique and complex needs of people with dementia.

As such, the home model is increasingly recognized as the ideal approach to dementia care.

It respects and honors the individual at every stage of their journey and encourages active participation and self-reliance.

 

Isn’t it what we all want ?

To be at home,

with a role

in a community

that supports us?