Decreasing spatial disorientation in care-home settings: How psychology can guide the development of dementia friendly design guidelines

O’Malley, Mary; Innes, Anthea; Wiener, Jan

doi:10.1177/1471301215591334

Cited by 53 publications

(66 citation statements)

References 46 publications

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“…Previous studies suggest contrast‐ and color‐based cues assist bathroom‐finding and reduce wandering for people with dementia, although evidence is limited . Motion‐based cues are promising, given how aspects of visual motion detection may be relatively preserved in tAD and PCA .…”

Section: Introductionmentioning

confidence: 99%

Navigational cue effects in Alzheimer's disease and posterior cortical atrophy

Yong

McCarthy

Poole

et al. 2018

Ann Clin Transl Neurol

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ObjectiveDeficits in spatial navigation are characteristic and disabling features of typical Alzheimer's disease (tAD) and posterior cortical atrophy (PCA). Visual cues have been proposed to mitigate such deficits; however, there is currently little empirical evidence for their use.MethodsThe effect of visual cues on visually guided navigation was assessed within a simplified real‐world setting in individuals with tAD (n = 10), PCA (n = 8), and healthy controls (n = 12). In a repeated‐measures design comprising 36 trials, participants walked to a visible target destination (an open door within a built environment), with or without the presence of an obstacle. Contrast and motion‐based cues were evaluated; both aimed to facilitate performance by applying perceptual changes to target destinations without carrying explicit information. The primary outcome was completion time; secondary outcomes were measures of fixation position and walking path directness during consecutive task phases, determined using mobile eyetracking and motion capture methods.ResultsResults illustrate marked deficits in patients’ navigational ability, with patient groups taking an estimated two to three times longer to reach target destinations than controls and exhibiting tortuous walking paths. There were no significant differences between tAD and PCA task performance. Overall, patients took less time to reach target destinations under cue conditions (contrast‐cue: 11.8%; 95% CI: [2.5, 20.3]) and were more likely initially to fixate on targets.InterpretationThe study evaluated navigation to destinations within a real‐world environment. There is evidence that introducing perceptual changes to the environment may improve patients’ navigational ability.

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Section: Introductionmentioning

confidence: 99%

Navigational cue effects in Alzheimer's disease and posterior cortical atrophy

Yong

McCarthy

Poole

et al. 2018

Ann Clin Transl Neurol

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“…The physical environment of the hospital was not considered to be in keeping with dementia‐friendly design principles (O’Malley, Innes, & Wiener, ). Participants acknowledged that the hospital setting could be disorientating for patients with dementia.…”

Section: Discussionmentioning

confidence: 99%

Dementia care in acute hospitals—A qualitative study on nurse managers’ perceived challenges and solutions

2020

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Aim The aim of this study was to explore the perceived challenges of nurse managers when caring for patients with dementia in acute hospitals and identify possible solutions to address these challenges. Background Although dementia care in acute hospitals is suboptimal, few solutions have been identified. Multi‐level factors need to be considered to promote changes in practice. Method Two focus groups were held with sixteen nurse managers responsible for eleven acute medical wards in Malta. Deductive qualitative analysis using an adapted version of McKinsey 7‐S model was used as an a priori framework to categorize the perceived challenges and solutions. Results The nursing managers identified a number of organizational challenges that have a direct impact on the quality of care of patients with dementia. They also suggested a number of solutions such as realigning the hospital strategy, improving training and care coordination, redesigning the ward environment and changing leadership styles. Conclusion This study highlight the complexity of improving dementia care in hospitals and continues to show that a system‐wide approach is needed. Implications for Nursing Management Understanding the challenges and identifying possible solutions can help hospital staff provide better person‐centred dementia care.

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“…The assessment tools were developed for hospitals, care homes, health center, and housing with care and were proven to be effective in both disseminating the principles of dementia-friendly designs and enabling improvements that led to a positive effect on patient outcomes and staff morale. A few other dementia-friendly studies had also focused on how psychology could guide the development of dementia-friendly design guidelines and what environmental designs were important to improve end of life care for PWD [39,40]. There was also a recent study evaluating both the physical and psychosocial care environments of hospital wards in the context of dementia care [41▪▪].…”

Section: Being Dementia Friendly In Healthcare Settingsmentioning

confidence: 99%

‘Dementia-friendly communities’ and being dementia friendly in healthcare settings

Lin

2017

Current Opinion in Psychiatry

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Purpose of review This review discusses the concept of ‘dementia-friendly communities’ and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. Recent findings Definitions of ‘dementia-friendly communities’ reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to ‘dementia-friendly communities’. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. Summary Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas – some may be achieved by environmental modifications while others may be improved by staff education.

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Decreasing spatial disorientation in care-home settings: How psychology can guide the development of dementia friendly design guidelines

Cited by 53 publications

References 46 publications

Navigational cue effects in Alzheimer's disease and posterior cortical atrophy

Navigational cue effects in Alzheimer's disease and posterior cortical atrophy

Dementia care in acute hospitals—A qualitative study on nurse managers’ perceived challenges and solutions

‘Dementia-friendly communities’ and being dementia friendly in healthcare settings

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