1. 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 ), 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