Effect of Built-Environment on the Behaviors of Residents with Dementia: A comparison of a small-scale unit and a traditional care unit Sookyoung Lee, Simon Fraser University, Vancouver, Canada Habib Chaudhury, Simon Fraser University, Vancouver, Canada Soojin Lee, Yonsei University, Seoul, Korea Measurement: February - March 2012 Physical Environmental Assessment Professional Environmental Assessment Protocol (PEAP) ii) Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH) Residents’ Behavioral Assessment Multidimensional Observation Scale for Elderly Subjects (MOSES) Minimum Data Set (MDS) Dementia Care Mapping (DCM)  Residents’ Behavioral Assessment INTRODUCTION No statistically significant differences were found in MOSES (Fig. 3). Relative to MDS, there was a statistically significant difference in the activity pursuit patterns (t (12) = 2.47, p<.05) (Fig. 4). For DCM, the most frequently observed behaviors were in the categories of articulation*, borderline**, food and nod*** (Fig. 5). However, there was a distinguishing difference in the cool**** category between the two groups (Edgewood Home: 1.0%, Marine Manor: 13.6%). * interacting with others ** being engaged but passively ***sleeping/dozing **** being disengaged The therapeutic role of physical environmental design for older adults with dementia is a growing concern among health care providers, architects and designers. Most of the traditional care facilities do not appropriately consider the special needs of persons with dementia, and in particular, lack creating supportive or responsive physical environment for their well-being. RESULTS positive positive PURPOSE 3.00 General Characteristics To examine the comparative effect of a purpose-built small-scale special care unit (SCU) and a traditional residential care unit on the behaviors among residents with dementia in Vancouver, Canada. Edgewood Home Marine Manor Age (mean) 81.9 years 79.3 years Gender Fe./ Male 3 (42.9%) /4 (57.1%) 4 (57.1%)/ 3 (42.9%) Stay Length (mean) 29.1 months 26.4 months ADL (mean) 61.4 57.6 Bedroom Type Single bedrooms Mixed single & semiprivate bedrooms Number of Residents 12 residents 30 residents Number of Staff 1.5 nurses/ 2 care aides 1 nurse/ 4 care aides 2.36 negative negative * Figure 3. Means of MOSES Figure 4. Means of MDS % METHOD 13.6 Study Subjects Figure5 . Distribution of DCM Random selection of 10 SCUs from a pool of facilities in Vancouver, Canada site visits & assessment Selection of total 14 residents from 2SCUs aged 65 + early- mid stage ambulated with/ without an assistive device Selection of 2 SCUs Edgewood Home: small scale unit Marine Manor: traditional care unit 1.0 Behavior Code Results of Statistical Analysis  Physical Environmental Assessment CONCLUSION Regarding the TESS_NH, there were significant differences in the stimulation(t(38)=2.19, p<.05) and personalization/ familiarity/ homelikeness (t (8)=4.43, p<.01) (Fig. 1). For PEAP assessment, there was a significant difference between the two SCUs (t (14) = 4.06, p<.001) (Fig. 2). Edgewood Home DCU Dining Room Living Room Corridor Private Room Residents in the small-scale environment were more engaged in activities and were more likely to respond in understanding the residents in the other facility. Residents living in the traditional unit exhibited few signs of interaction/engagement with anyone/ anything around them. Familiarity of the homelike small-scale environment in the purpose-built care unit can help reduce withdrawn and apathetic behaviors among the residents. Context of a familiar home environment offers a more cognitively comprehensible experience for older adults with dementia. mean score Marin Manor DCU Corridor Living Room Private Room Dining Room 1.50 1.40 0.20 0.95 Acknowledgements The authors acknowledge the Basic Science Research Program of the National Research Foundation of Korea for funding this research (Grant No. 2011-0009776), special thanks to the older adults and staff in Edgewood Home and Marine Manor for their help with the research. * Figure 1. Means of TESS_NH Figure 2. Scores of PEAP