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If you don't speak or interact - you can and will lose words and stop being able to process conversations and interact properly. If you don't use your mind - you can lose skills that you have previously engaged easily.
Institutional dementia - is the same concept - just in a group setting. The residents who tend to get institutional dementia in a group setting, are those who refuse to leave their rooms, who refuse to engage with other people in a social setting, who self-isolate and will not engage unless they need something. When you sit or lay in a room all day, and have no outside stimulation - your brain begins to forget how to react appropriately to stimuli.
Now...to answer your question - does being in a facility outside the home accentuate dementia?
Well if a person HAS dementia - they have it. it can get very bad at home and home caregivers have to ensure that they are on their guard at all times. They have to look out for escapism, and anger and fear and hallucinations and everything that comes with it. And they have to be on their toes 24/7. If that same person is isolated at home- the lack of stimulation makes things worse.
It really depends on what their home life is like. Are they surrounded by stimuli all the time and engaging and participating in conversations? Or are they just self-isolating - which is no different than being in a managed care facility.
The long and the short of it is that someone with dementia can be isolated anywhere.