This study compared 12 residents of a dementia special care unit (SCU) and 8 residents of a segregated but not specialized dementia unit in another nursing home, to test the impact of specialized care on longitudinal (13-15 months) change in behavior and cognition. The SCU model included specialized elements in activities, staff selection and training, physical environment, and family involvement. Longitudinal results indicated no superior outcomes on the SCU. Possible interpretations discussed include limited benefit of SCU care over segregated but nonenriched care, methodological limitations of the current study, distinctions between individualized and programmatic behavior modification approaches, and the need to examine quality of life as a SCU outcome.