Small-scale long-term care settings

Traditional long-term care settings

Home-like, holistic and person-centred approacha

Medical- and nursing based approach

Focus on the normalization of living and maintenance of one’s original lifestyle

Focus on care

Additional focus on client interaction

Main focus on basic technical care giving skills

Participation in daily activities is stimulated

Staff performs most daily activities

Groups are relatively small (usually 6 – 8)

Groups are larger (usually >20)

Day schedule according to resident’s preferences

Routine institution directed day schedule

Environment is familiar and home-like

Environment is hospital-like

Number of caregivers is smaller

Number of caregivers is larger

Staff wears no uniforms

Staff wears uniforms

Staff tasks are integrated b

Staff tasks are more differentiated b

More individual decision making by staff members

More collective decision making by staff members

a This means that the vision of small-scale living is to provide care that fits into the lifestyle that people were used to in their own home (home-like), that encompasses all aspects of people's needs, psychological, physical and social should be taken into account and seen as a whole (holistic) and of which the focus is on the needs of the individual resident (person-centred)
b In traditional long-term care settings staff members usually carry out a specific part of the care tasks. Tasks are thus differentiated between staff members. In small-scale long-term care settings staff members carry out all different tasks, such as cooking and social activities, as well as technical care giving tasks. Thus in these settings there is almost no task specialization.
Table 1: Itemized summary of the key differences between small-scale and traditional long-term care settings.
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