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intellectual disabilities affected by dementia were studied to determine: (1) what
are the physical characteristics of the homes; (2) what physical environmental
adaptations have been made in response to behavioral deterioration expressed by
residents with dementia; and (3) what are the demands on staff resulting from
dementia care. The first sample of group homes in five countries provided
comparative international data on home designs, staffing, costs, and residents. The
second sample, drawn from homes in the USA and the UK, provided data on the impact
of dementia. Findings revealed staffing and design of homes varied but generally
abided by general practices of dementia care; homes relied on existing resources to
manage changes posed by dementia care; programmatic and environmental adaptations
were implemented to address progression of dementia; and residents with dementia
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