SOCIAL NETWORK BY ENVIRONMENTAL DESIGN: FACILITATING THERAPEUTIC EFFECT IN LTCF FOR PEOPLE EXPERIENCING DEMENTIA

Abstract The relationship between the physical environment and the prevalence of social interaction have been a core topic of inquiry in environmental gerontology. It has been estimated that around 25 million people worldwide have dementia, and the number will exceed 80 million by 2040. A growing body of literature in the areas of environment-behavior studies shows that the physical environment affects positive behavioral changes, in turn, affecting individual, group and organizational outcomes, but little research has focused on older adults especially those with cognitive impairment by targeting the Dementia Enabling Environment of care facilities. By using non-pharmacological interventions, the purpose of this study is to initiate positive social network among dementia residents and staff by analyzing the spatial configuration of the physical environment and layout in long-term care facilities (LTCF). The findings may give evidence-based design guidelines for future research and design of memory care facilities to promote therapeutic experience for older people experiencing early to moderate stage dementia. Using a 3-stage, multi-method research design such as space syntax, behavior mapping techniques and direct observations, this study objectively measured the spatial configuration of LTCF (physical environment) to evaluate the provision of social interactions (among dementia residents and staff), promote positive health outcomes and healthy living for people experiencing early to moderate stage dementia. This study was able to establish that the architectural layout and environmental design could have a positive and protective effect against dementia in environmental gerontology and geriatrics.

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A Systems Framework for Understanding the Environment’s Relation to Clinical Teamwork: A Systematic Literature Review of Empirical Studies

Environment and Behavior ◽

10.1177/0013916518815535 ◽

2018 ◽

Vol 52 (7) ◽

pp. 726-760

Author(s):

Erin Peavey ◽

Hui Cai

Keyword(s):

Health Care ◽

Systems Engineering ◽

Physical Environment ◽

Empirical Studies ◽

Health Care Facilities ◽

Future Research ◽

Health Care Outcomes ◽

Care Facilities ◽

Care Outcomes ◽

Systems Framework

Clinician teamwork is effective at improving many health care outcomes, and the physical environment is an important part of a system that facilitates teamwork. This review critically evaluates and synthesizes the empirical evidence on the impacts of the physical environment and surrounding ecosystem on clinician teamwork in health care facilities using a systems-based lens. The systematic search yielded 2,323 titles and abstracts between 2007 and 2017, which were reviewed and resulted in 34 articles examining physical environment’s impact on clinician teamwork. The Systems Engineering for Patient Safety (SEIPS) framework is utilized to thematically structure findings to examine the interdependent nature of built and nonbuilt factors that have a documented impact on clinician teamwork. This study found consistent evidence of the interdependence of these systems factors in facilitating or hampering teamwork, as defined by Salas and colleagues’ “Big Five.” The review identifies current gaps in the literature and suggests where future research is needed.

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How Do We Get to Causal Clarity on Physical Environment-Crime Dynamics?

10.1093/oxfordhb/9780190279707.013.2 ◽

2018 ◽

Author(s):

Ralph B. Taylor

Keyword(s):

Land Use ◽

Crime Prevention ◽

Physical Environment ◽

Final Section ◽

Space Syntax ◽

Environmental Design ◽

Environmental Criminology ◽

Future Research ◽

Defensible Space ◽

Deep Sense

This chapter discusses research and theorizing about the crime impacts of the physical environment, relating it to past reviews of scholarship in this area, and highlighting the crucial question of causality. It introduces key stumbling blocks in community criminology that must be addressed before scholarship can advance on the crucial causality question. Environmental criminology in a deep sense represents a field within a broader field of community criminology. The chapter underscores just a few of the most important recent works in four select areas within the physical environment-crime scholarship: space syntax, facilities and land use, accessibility/permeability, and crime prevention through environmental design/defensible space. The final section sketches one possible avenue for future research which can address these concerns.

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ENVIRONMENTAL DESIGN AND QOL IN LONG-TERM CARE FACILITIES

Innovation in Aging ◽

10.1093/geroni/igx004.2868 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 792-792

Author(s):

S. Brennan ◽

H. Osada ◽

T. Doan ◽

D. Yee-Melichar

Keyword(s):

Long Term Care ◽

Environmental Design ◽

Term Care ◽

Care Facilities

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Comparing standards and guidelines of long-term care facilities based on physical environment and manpower in Korea, Japan, USA, and Australia

Health Policy and Management ◽

10.4332/kjhpa.2012.22.3.403 ◽

2012 ◽

Vol 22 (3) ◽

pp. 403-426 ◽

Cited By ~ 2

Author(s):

Young-Ran Chin ◽

Hyo Young Lee

Keyword(s):

Physical Environment ◽

Long Term Care ◽

Term Care ◽

Care Facilities ◽

Standards And Guidelines

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Psychogeriatric Care: Problems and Challenges

Healthcare Management Forum ◽

10.1016/s0840-4704(10)61334-8 ◽

1988 ◽

Vol 1 (3) ◽

pp. 31-36

Author(s):

Douglas H. Rapelje

Keyword(s):

Physical Environment ◽

Long Term Care ◽

Initial Step ◽

The Elderly ◽

Homes For The Aged ◽

Term Care ◽

Care Facilities ◽

Trained Staff ◽

Care Problems

From the aspect of homes for the aged, understanding the needs of the elderly mentally frail is the initial step to providing more suitable conditions. Many of the traditional features of these long-term care facilities need to be questioned and challenged. Care does not stop at the physical environment, indeed it goes even beyond establishing excellent relationships with the families involved and a caring, well-trained staff. Stress is needed on emphasizing the resident's remaining capacities and skills, not on behavioural problems.

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Screening for mental disorders in residential aged care facilities

International Psychogeriatrics ◽

10.1017/s1041610210000128 ◽

2010 ◽

Vol 22 (7) ◽

pp. 1107-1120 ◽

Cited By ~ 14

Author(s):

Nancy A. Pachana ◽

Edward Helmes ◽

Gerard J. A. Byrne ◽

Barry A. Edelstein ◽

Candace A. Konnert ◽

...

Keyword(s):

Task Force ◽

Aged Care ◽

Residential Aged Care ◽

Future Research ◽

Screening Instruments ◽

Term Care ◽

Care Facilities ◽

Aged Care Facilities ◽

Residential Aged Care Facilities ◽

Brief Screening

ABSTRACTIntroduction: The International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care Facilities seeks to improve care of persons in residential aged care facilities (RACFs). As part of that effort the current authors have contributed an overview and discussion of the uses of brief screening instruments in RACFs.Methods: While no current guidelines on the use of screening instruments in nursing homes were found, relevant extant guidelines were consulted. The literature on measurement development, testing standards, psychometric considerations and the nursing home environment were consulted.Results: Cognitive, psychiatric, behavioral, functional and omnibus screening instruments are described at a category level, along with specifics about their use in a RACF environment. Issues surrounding the selection, administration, interpretation and uses of screening instruments in RACFs are discussed. Issues of international interest (such as translation of measures) or clinical concern (e.g. impact of severe cognitive decline on assessment) are addressed. Practical points surrounding who can administer, score and interpret such screens, as well as their psychometric and clinical strengths more broadly, are articulated.Conclusions: Guidelines for use of screening instruments in the RACF environment are offered, together with broad recommendations concerning the appropriate use of brief screening instruments in RACFs. Directions for future research and policy directions are outlined, with particular reference to the international context.

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Staff perspectives on the role of physical environment in long-term care facilities on dementia care in Canada and Sweden

Dementia ◽

10.1177/14713012211003994 ◽

2021 ◽

pp. 147130122110039

Author(s):

Sook Young Lee ◽

Lillian Hung ◽

Habib Chaudhury ◽

Agneta Morelli

Keyword(s):

Job Satisfaction ◽

Focus Group ◽

Physical Environment ◽

Long Term Care ◽

Institutional Setting ◽

Care Practice ◽

Term Care ◽

Care Facilities ◽

Care Practices

Objectives This study aimed to explore staff perspectives of the physical environment in supporting their care practices for residents living with dementia in Canadian and Swedish long-term care facilities. Design An exploratory, descriptive, qualitative research design based on focus groups was used. Participants A total of 24 staff members who worked closely with the residents such as nurses or care aides participated in the focus group interviews from four facilities, two in Sweden and two in Canada. Measurements Focus group interview was held at each selected care facility once and a total of four times were conducted. Broad questions were asked about the effect of physical environment on care practice, job satisfaction, and interaction with residents. Data were analyzed by thematic analysis. Findings This study identified three environmental themes that have substantial effect on the social interaction and care practice: (i) design ambience enables and limits social and care interaction, (ii) space arrangements facilitate and hinder the effectiveness of care delivery, and (iii) sensory stimuli have direct impact on residents. The findings demonstrate that well-designed environment qualities such as homelike ambience, an open layout, and stimulating courtyard positively stimulate the emotion of staff as well as residents, which also leads to build trust and relationship and to increase job satisfaction. The study found that the appropriate level of sound or familiar music for residents with dementia is a positive stimulus. When the staff felt comfortable and supported by good care unit’s ambience, they can be motivated to care for their residents, leading to better care practices. The study also found that the closed floor plan in an institutional setting could increase staff fatigue by obstructing the view of residents’ behaviors and movement and by increasing walking loads. Conclusions This study highlights the complexities of how care was organized and influenced by the physical environment of the setting. The variations in the physical environmental characteristics and quality of care suggest the value of comparative research in identifying and exploring the possible causes and consequences. Future development in long-term care facilities requires a better understanding of staff experiences and staff involvement in the physical design of care settings.

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Innovating dementia care; implementing characteristics of green care farms in other long-term care settings

International Psychogeriatrics ◽

10.1017/s1041610217002848 ◽

2018 ◽

Vol 30 (7) ◽

pp. 1057-1068 ◽

Cited By ~ 11

Author(s):

Yvette Buist ◽

Hilde Verbeek ◽

Bram de Boer ◽

Simone R. de Bruin

Keyword(s):

Physical Environment ◽

Long Term Care ◽

Well Being ◽

Dementia Care ◽

Small Scale ◽

Term Care ◽

Care Facilities ◽

Facilitators And Barriers ◽

Green Care Farms

ABSTRACTBackground:People with dementia at green care farms (GCFs) are physically more active, have more social interactions, are involved in a larger variety of activities, and come outdoors more often than those in other long-term dementia care settings. These aspects may positively affect health and well-being. This study explored which and how characteristics of GCFs could be implemented in other long-term dementia care settings, taking into account possible facilitators and barriers.Methods:Semi-structured interviews were conducted with 23 professionals from GCFs, independent small-scale long-term care facilities, and larger scale long-term care facilities in the Netherlands. The framework method was used to analyze the data.Results:Several characteristics of GCFs (e.g. homelike aspects, domestic activities, and access to outdoor environments) have already been applied in other types of long-term dementia care settings. However, how and the extent to which these characteristics are being applied differ between GCFs and other types of long-term dementia care settings. Facilitators and barriers for the implementation of characteristics of GCFs were related to the physical environment in which the care facility is situated (e.g. the degree of urbanization), characteristics and competences of staff members (e.g. flexibility, creativity), characteristics and competences of managers (e.g. leadership, vision), and the political context (e.g. application of risk and safety protocols).Conclusion:Several characteristics can be implemented in other dementia care settings. However, to realize innovation in dementia care it is important that not only the physical environment but also the social and organizational environments are supporting the process of change.

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Geographic Variation in Pneumonia and Influenza in Long-Term Care Facilities: A National Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa081 ◽

2020 ◽

Vol 71 (8) ◽

pp. e202-e205 ◽

Cited By ~ 1

Author(s):

Elliott Bosco ◽

Andrew R Zullo ◽

Kevin W McConeghy ◽

Patience Moyo ◽

Robertus van Aalst ◽

...

Keyword(s):

Geographic Variation ◽

Long Term Care ◽

Care Facility ◽

The United States ◽

National Study ◽

Future Research ◽

Term Care ◽

Long Term Care Facility ◽

Care Facilities

Abstract There is large county-level geographic variation in pneumonia and influenza hospitalizations among short-stay and long-stay long-term care facility residents in the United States. Long-term care facilities in counties in the Southern and Midwestern regions had the highest rates of pneumonia and influenza from 2013 to 2015. Future research should identify reasons for these geographic differences.

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