Staff Ratios and Resident Outcomes in Special Care Units: Do Activity Aides Make a Difference?

This study examines the effect of activity aide—to-resident ratios on outcomes of special-care-unit residents over a 1-year period following admission. Existing studies focusing on the effects of staff ratios on resident outcomes tend not to separate activity aides from other types of staff, if they study them at all. However, research on best care practices in special care units for persons with dementia has established the importance of activities for optimal resident outcomes. Employing multiple regression analyses, this study finds evidence that increased activity aide— to-resident ratios have positive effects on three resident outcomes—expressive language skills, social skills, and cognitive function—when controlling for resident characteristics, facility characteristics, and environmental design. It is concluded that because activity aide—to-resident ratios tend to be very low yet appear to have a significant positive effect on resident outcomes, a modest increase in activity aide—to-resident ratios would be beneficial for residents with dementia in special care units.