This study is a multi-method, intrinsic case study of social interaction in a special care unit (SCU) for cognitively impaired older persons. It is found that residents are capable of developing a range of social bonds even though the SCU in question is found to have several organizational and physical factors that unwittingly thwart its therapeutic potential. These limitations are illuminated by consideration of the congruence between the conceptualization of the dining areas held by staff and that held by residents as revealed through the process of negotiation occurring in social interaction. The study adopts an environment-behavior perspective following the theoretical development of Lawton (1986) and merges it with the qualitative approach to place pursued by Goffman (1961) and Gubrium (1978). It is suggested that a focus on place as a unit of analysis offers potential for bridging Quality of Life with the cognitively impaired.
Objective: Neighborhood characteristics may be important for promoting walking, but little research has focused on older adults, especially those with cognitive impairment. We evaluated the role of neighborhood characteristics on cognitive function and decline over a 2-year period adjusting for measures of walking. Method: In a study of 64 older adults with and without mild Alzheimer’s disease (AD), we evaluated neighborhood integration and connectivity using geographical information systems data and space syntax analysis. In multiple regression analyses, we used these characteristics to predict 2-year declines in factor analytically derived cognitive scores (attention, verbal memory, mental status) adjusting for age, sex, education, and self-reported walking. Results: Neighborhood integration and connectivity predicted cognitive performance at baseline, and changes in cognitive performance over 2 years. The relationships between neighborhood characteristics and cognitive performance were not fully explained by self-reported walking. Discussion: Clearer definitions of specific neighborhood characteristics associated with walkability are needed to better understand the mechanisms by which neighborhoods may impact cognitive outcomes. These results have implications for measuring neighborhood characteristics, design and maintenance of living spaces, and interventions to increase walking among older adults. We offer suggestions for future research measuring neighborhood characteristics and cognitive function.
This article presents an emergent heuristic framework for the core environmental gerontology concept of "place." Place has been a central concern in the field since the 1970s (Gubrium, 1978) for its hypothesized direct relationship to identity, the self, and agency--suggestive of the appropriateness of lateral theoretical linkages with developmental science. The Ecological Framework of Place (EFP) defines place as a socio-physical milieu involving people, the physical setting, and the program of the place, all catalyzed by situated human activity and fully acknowledging that all four may change over time. The article begins with a concise overview of the EFP before moving on to consider it within three theoretical terrains: place theory, developmental science theory, and environmental gerontology theory. The EFP will be argued to be a place theory which subsumes themes of emergent environmental gerontology theories within a developmental science perspective. Implications for theory, method and practice are discussed. One of the strengths of the model is its ability to serve both research and practice, as is exhibited in its ability to incorporate applied design research and inform architectural decision-making so often lacking in other environmental gerontology models. Place should be viewed as an integrative concept providing opportunities for both environmental gerontology and developmental science to more critically concern the profound role places have in terms of agency, identity and sense of self over the life course.
This study is a multi-method, intrinsic case study evaluation of social interaction understood as a global dimension of Quality of Life (QOL) in a special care unit (SCU) for cognitively impaired older persons. The study proposes an initial means for describing and evaluating the social affordance of a place. Through the accumulation of similar case studies, care practice can make better informed decisions because of an awareness of successful or unsuccessful patterns that begin to emerge in the descriptive data. Reflecting the improvement-orientation of the evaluation, the SCU in question is found to have several factors-organizational and physical in nature which unwittingly thwart the therapeutic benefit of social interaction. The case study adopts an environment behavior perspective following the theoretical development. The focus of the evaluation is the consensual and social-normative aspects of social interaction.
The popularity of the concept of evidence-based design (EBD) has exploded over the past five years, picking up speed as a topic of attention in environmental design conferences, papers and articles, and books. Rooted in the healthcare environment, the EBD concept has now bridged out to design of long-term care settings, housing and workplaces, as well as facilities management. While evidence-based design is indeed a seductive term for those of us interested in advancing research-informed design – portending linkages between research-derived evidence and environmental design – we cautiously note that, as of this writing, in its current conceptualisation, its clout is stronger than its clarity. This paper is a clarion invitation to the environmental design research community to consider the concept of evidence-based design as emergent, warranting careful, critical examination regarding its meaning and underlying assumptions.
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