1. Mixed Methods FINDINGS
THOUGHTFUL DESIGN: MEASURING POSITIVE CHANGES IN ENGAGEMENT LEVELS IN RESIDENTIAL SETTINGS FOLLOWING DESIGN CHANGE FOR OLDER ADULTS
Mark Morgan-Brown Joan Brangan
TMU = Traditional Model Units
HMU = Household Model Units
Mixed Methods FINDINGS
Post renovation staff and relative interviews (n=38) gave insight into how and why the changes in physical design, operational policies and social culture increased interactive occupation and social engagement levels which provided convergence with the quantitative data
Environmental Design Features which improve interactive occupation and social engagement:
Open plan
Functioning kitchen
Staffed with homemaker
Requiring operational changes to create flexibility and spontaneity
Using a person-centred care framework .
Interactive occupation and social engagement were significantly increased in the HMUs over the TMUs, particularly for residents.
THE ASSESSMENT TOOL FOR OCCUPATION AND SOCIAL ENGAGEMENT (ATOSE).
Provides a snapshot observational to define, compare and evaluate communal spaces in order to understand and improve the living, working and visiting environment.
KEY FINDINGS:
When comparing the TMU and the HMU environments, the ATOSE measured statistically different levels of interactive occupation and social engagement for residents, staff and visitors.
WHAT THIS STUDY HAS ADDED:
Levels of interaction and social engagement can be measured and monitored within residential and day care environments. In this way, poorly functioning environments can be identified and improved leading to increased quality of life for older adults who use these environments.
In the HMUs, residents spent more time interacting and engaging with others in the room. The HMU open plan room with kitchen and the homelike environment stimulated them to increase their levels of interactive occupation.
In the HMUs the staff spent more time interacting and engaging with residents (and others). Essential staff modifications were: the creation of the homemaker role, the development of a person centred culture and creating unforced routines.
In the HMUs, visitors increased their levels of social engagement, as they were positively influenced by the homelike features (comfy settees, accessible dining tables and entrance through a household front door).
Morgan-Brown, M. & Chard, G. (2014) Comparing communal environments for those with dementia: Using interactive occupation and social engagement as outcomes. British Journal of Occupational Therapy, 77(2), 50-58
Morgan-Brown, M., Newton, R. & Ormerod, M. (2013) Engaging life in two Irish nursing home units for people with dementia: Quantitative comparisons before and after implementing household environments, Aging & Mental Health, 17(1), 57-65