1. Design of a Research Study on the influence of the Household Model in nursing homes Mark Morgan-Brown Dympna Manley Marcus Ormerod Rita Newton SURFACE Inclusive Design Research Centre University of Salford, England

2. Presentation Outline Background context Background context Household Model for nursing homes Household Model for nursing homes Design objectives Design objectives Photographs Photographs Research methodology Research methodology

3. An Ageing World:2008 U.S. Census Bureau: International Population Reports Kinsella and He (2009) Social Phenomenon without Precedent 2040 World Population ↑160% aged 65+ ↑160% aged 65+ ↑233% aged 80+ ↑233% aged 80+

4. Alzheimer’s Association, 2009 USA Sixth leading cause of death Sixth leading cause of death Dementia prevalence age 65 = 1 person in 8 age 85 = 30-45%

5. Dementia is overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. Dementia: 25.1% Stroke: 11.4% Limb impairment: 10.5% Arthritis:9.9% Depression:8.3% Eyesight: 6.8% Gastrointestinal:6.5% Dementia is overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. Dementia: 25.1% Stroke: 11.4% Limb impairment: 10.5% Arthritis:9.9% Depression:8.3% Eyesight: 6.8% Gastrointestinal:6.5% Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey Sousa, Ferri, Acosta, Albanese, Guerra, et al. The Lancet, 366, 9503, 2112-2117 Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey Sousa, Ferri, Acosta, Albanese, Guerra, et al. The Lancet, 366, 9503, 2112-2117

6. UK: RISING TIDE OF DEMENTIA (2031) UK figures as reported in: Comas-Herra, et.al. (2007) International Journal of Geriatric Psychiatry, 22, 1037-1045 0.96% of GDP 0.96% of GDP 88% increase in number of people in care homes 88% increase in number of people in care homes

8. RESIDENTIAL CARE Mozley (2001) J of Occ Science Predictors of death (9 months post admission) 1. Barthel Activities of Daily Living 2. Cancer, acute infection, endocrine or cardiovascular disorders 3. Little satisfaction with daily occupations

9. Doing as much as I can do: The meaning of activity for people with dementia Phinney, Chaudhury, O’Connor, Aging & Mental Health, 2007, 11(4), 384-393 Community dwelling elders with mild to moderate dementia Familiar social + physical environment Meaning IdentityPleasure Continuity ConnectionBelonging Occupation

10. Household Components Calkins. (2009) Evidence based long term care design. NeuroRehabilitation 25, 145-154

11. Household Model Principles Each household is a person’s home Each household is a person’s home The kitchen becomes the focus The kitchen becomes the focus Residents participate in meal preparation / household activities Residents participate in meal preparation / household activities

12. Pre-Renovation

13. Post-Renovation

14. Pre-Renovation

15. Post-Renovation

17. Post-renovation

21. Methods Qualitative Interviews staff and relatives Interviews senior management Quantitative Direct snapshot observation Attitude surveys staff and relatives

22. The authors thank the Managements of the Moorehall Lodge, Ardee, Co. Louth and Castleross Nursing & Convalescent Centre, Carrickmacross, Co. Monaghan. The authors thank the Managements of the Moorehall Lodge, Ardee, Co. Louth and Castleross Nursing & Convalescent Centre, Carrickmacross, Co. Monaghan. The authors also wish to acknowledge the Residents, Staff and Visitors who contributed to this research project. The authors also wish to acknowledge the Residents, Staff and Visitors who contributed to this research project. Mark Morgan-Brown wishes to thank Homecare Medical Supplies, Ballyhaunis, Co. Mayo for their generous funding, which enabled this AOTI conference presentation. Mark Morgan-Brown wishes to thank Homecare Medical Supplies, Ballyhaunis, Co. Mayo for their generous funding, which enabled this AOTI conference presentation.

23. Mark Brown, Occupational Therapy Specialist in Inclusive Design for People with Dementia Cavan, Ireland mark.brown@hse.ie