The Physical Environment of Nursing Homes for People with Dementia: Traditional Nursing Homes, Small-Scale Living Facilities, and Green Care Farms

Abstract

It is well recognized that the physical environment is important for the well-being of people with dementia. This influences developments within the nursing home care sector where there is an increasing interest in supporting person-centered care by using the physical environment. Innovations in nursing home design often focus on small-scale and homelike care environments. This study investigated: (1) the physical environment of different types of nursing homes, comparing traditional nursing homes with small-scale living facilities and green care farms; and (2) how the physical environment was being used in practice in terms of the location, engagement and social interaction of residents. Two observational studies were carried out. Results indicate that the physical environment of small-scale living facilities for people with dementia has the potential to be beneficial for resident’s daily life. However, having a potentially beneficial physical environment did not automatically lead to an optimal use of this environment, as some areas of a nursing home (e.g., outdoor areas) were not utilized. This study emphasizes the importance of nursing staff that provides residents with meaningful activities and stimulates residents to be active and use the physical environment to its full extent.

Creating Age-Friendly Communities: Housing and Technology

“…This special issue of Healthcare on "Creating Age-Friendly Communities: Housing and Technology" is timely, comprising twelve papers [16][17][18][19][20][21][22][23][24][25][26][27] that traverse and intersect across the fields of gerontology, health and social care, social sciences and gerontechnology.…”

“…There are currently over 47 million people worldwide living with dementia and this number is projected to increase to 75 million by 2030, and 135 million by 2050 [28]. Thus, the accepted papers surrounding dementia have focused on the perspectives of healthcare professionals in conjunction with meaningful activities for individuals diagnosed with dementia residing in a nursing home environment [16,25], and installing and using aids and adaptations within the home to create a physical environment that is more dementia-friendly [19]. Furthermore, exploring and understanding technology use associated with care of individuals living with dementia in the community from the perspective of stakeholders [23] is equally important as a systematic review to ascertain the current landscape and offer readers the ability to see what areas need greater improvement and expansion.…”

“…Five papers [16,17,19,20,23] take the standpoint of technology use and deployment within various social contexts as a means of contributing to the national and international discussions and debates surrounding the age-friendly landscape. Across these accepted papers, we have demonstrated the growth in multi-and-cross disciplinary research, which intersects at various disciplines across academia but also at policy levels associated with national [29] and devolved governments [30,31].…”

“…Living arrangements and environments in the broadest sense are explored in this volume of work as to how they impact on ageing. Supporting nursing home residents in meaningful activities [25], the impact of living alone [22], the use of aids and adaptations to support well-being [19] and the importance of public green space [16,26] all contribute to a discussion as to how to create an age-friendly environment. Importantly, a number of included papers highlight the 'expert' role older people have in their daily experience of the environments in which they live [26] and research in this area needs to move away from technological innovations that are not rooted in this expertise.…”

Nursing home care for people with dementia: Update of the design of the Living Arrangements for people with Dementia (LAD)‐study

“…Items are scored on a 5-point Likert scale, ranging from 1 'none of the time' to 5 'all of the time', with a higher score indicating more unity. The questionnaire was completed by care staff.To measure the care environment in the care homes, a checklist was filled in by the research assistant(de Boer et al, 2018). The checklist in the current study consisted of 69-items using a 5-point Likert scale -ranging from 1 'totally disagree' -5 'totally agree' -divided into six themes: privacy and autonomy, sensory stimulation, view and nature, facilities, orientation and routing and small-scale living homes characteristics.…”