The evidence is nuanced. Some studies have suggested that people with dementia admitted to care homes show faster functional decline, but this is often because admission tends to happen at a point of crisis. The care home setting itself is not necessarily the cause of the decline. High-quality nursing homes with person-centred dementia care, therapeutic activities, good nutrition, and well-trained consistent staff can slow decline and maintain quality of life. Institutionalised environments with poor care and high staff turnover are associated with worse outcomes.