National Preventive Mechanism of preventive and human rights monitoring (e.g. for risk assessment in connection with fall prevention, pain, hygiene, malnutrition, skin damage) – require a reorientation and professionalisation of care in all the Laender. Additionally, most of the residents are already very elderly (over 85) when they enter such institutions and facilities and require a high degree of care due to chronic illnesses and multiple ailments. The challenge of dementia Advanced-state dementia is the most frequent reason for moving into care facilities, especially for people who live alone. Limiting factors for continuing to live at home include but are not limited to faecal incontinence, dangers in the home and behavioural disorders associated with dementia. Experts emphasise that persons with dementia whose illness is well controlled with anti-dementia drugs and their environment have an advantage with regard to ease of care and independent living. Unless there is a breakthrough with regard to prevention and therapy, in Austria the number of persons with dementia will rise from 90,500 in 2000 to around 233,000 in 2050. These are all persons with moderate to serious dementia with a high need for help and care. Due to this situation, knowledge about geriatric psychiatric care and palliative nursing and medical care and the best possible ongoing medical care in retirement and nursing homes are becoming increasingly important. The expectations of relatives with regard to what these institutions and facilities as people’s last residence are expected to do with regard to longterm care are also rising accordingly. This is not just about basic care (“warm, well-fed, clean”), but also about psychosocial and rehabilitative care of geriatric patients. By providing special arrangements with regard to space, staff and everyday needs, it is possible to support care of persons with dementia in respect of their special needs, such as, increased urge to move around, inversion of day and night rhythm, as well as behavioural abnormalities. This requires resources. Harmonisation of framework conditions necessary How much staff is necessary and according to what formula this is calculated or what qualifications staff must have differs from Land to Land. In order for nursing staff to provide modern, professional care in accordance with the current standards developed by science and research in individual areas, there must be a uniform basis across Austria for how to calculate staff needs and unified structural parameters (staff ratio and qualification formula, home size, equipment and uniform quality assurance). All of this does not exist at the moment. The impressions that the commissions receive during their visits in this type of facilities are correspondingly diverse. The commissions often face complaints from the staff about too few resources, in particular for the care of elderly persons with dementia. Positive reactions to commission visits It should be positively highlighted that institutions and facilities perceive and accept the commissions’ suggestions as feedback and have provided assurances that improvements will be made. Whether these assurances have been fulfilled is monitored by the NPM during follow-up visits or subsequent 78