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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Margaret Hegge


dementia patient long-term care, employees of long-term care facilities, evaluation of nursing home care


The purposes of this study were to describe the: 1) staff to resident ratios in special care units (SCUs) for residents with dementia, 2) incidence of falls, urinary tract infections and significant weight loss in SCUs, 3) relationship between the staff to resident ratios and the incidence of falls, urinary tract infections (UTIs) and significant weight loss, 4) proportion of Medicaid census for facilities with SCUs, 5) relationship between Medicaid census and staff to resident ratios, 6) level of programmed activity in SCUs, 7) relationship between the level of programmed activity and the incidence of falls and significant weight loss, and 8) staffing patterns during the week and weekend. Questionnaires were sent to 61 administrators of long-term care facilities (LTCFs) that have a SCU. Fifty-one questionnaires were returned. Descriptive statistics were performed on the data for incidence and Pearson r correlations were completed on tests of relationships. The only statistically significant relationship found between staff to resident ratios and quality indicators was between night nursing staff and the percent of residents experiencing one fall during a 6 month period. The study revealed a relationship between hours of programmed activity offered and the percent of residents experiencing one fall. Interestingly, participation in the activities did not have a significant relationship with falls. Additional findings include a relationship between the percent of residents with one UTI and the percent of residents with two or more UTIs per facility for the six month period. The study also found a relationship between the percent of residents experiencing two or more UTIs and the percent of residents experiencing two or more falls. Finally, the data demonstrated a strong correlation between staffing patterns within facilities. If a facility had low staff to resident ratios for one shift of total staff, nursing staff or nurse assistant staff, it is also likely that the other shifts and staff were also low. Dementia is a progressive and debilitating disease primarily effecting our fastest growing population - the elderly. This population experiences unique needs from those in traditional LTCFs. This research has implications for adequately staffing, particularly the night shift. The incidence of UTIs and weight loss also suggest that a large portion of facilities or local health care providers are proactive to the challenge of minimizing these conditions. Facility networking may improve the incidence of these two conditions.

Library of Congress Subject Headings

Dementia -- Patients -- Long-term care
Long-term care facilities -- Employees
Nursing home care -- Evaluation



Number of Pages



South Dakota State University


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